Maternal Mortality in the Obstetrics and Gynecology Service of Regional Hospital Center of Ouahigouya: Epidemiological, Etiological Aspects and Contributing Factors—About 151 Cases Collected in Three Years from 1st January 2013 to 31 December 2015

The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from 2013 to 2015. We carried out a descriptive and analytical study on maternal deaths in maternity of the RHC of Ouahigouya, including all patients who died in the obstetrics and gynecology department of the RHC of Ouahigouya from 1 January 2013 to 31 December 2015, which meets WHO’s definition of maternal death. We recorded 151 maternal deaths and 5481 live births, a maternal mortality ratio of 2755 per 100,000 live births. The most affected women were women aged 20 - 24 years (27.8%), multiparous (25.5%), married women (88.7%) and those without income-generating activities (85.4%). The main causes of death from direct obstetrical complications were hemorrhage (38.3%), infections (21.5%), abortions (16.8%) and complications of hypertension disorders (15.8%) and for indirect obstetrical complications, malaria (36.6%), anemia (29.5%), and HIV/AIDS (9.1%). Contributing factors to maternal deaths prior to admission were delay in referral (33.3%) and delay in transfer (31.5%) and delay in admission (32.8%) and delay in diagnosis (23.4). From our study, it appears elsewhere as well as that most maternal deaths are preventable, hence the need for coordinated actions to effectively fight against maternal mortality.

The application of the “Treatment in Accordance with Three Categories of Etiologic Factors” theory in the prevention and treatment of epidemic diseases in traditional Chinese medicine since the Ming and Qing Dynasties

“Treatment in accordance with three categories of etiologic factors”(consideration of the climatic and seasonal conditions,environment and individual’s constitution in the treatment of diseases),that is,treatment following time,place and individual,is one of the basic principles followed by Chinese medicine in the clinical treatment of diseases.This paper analyzes the similarities and differences in traditional Chinese medicine treatment of patients with epidemic diseases in different regions and periods since the Ming(1368-1644 C.E.)and Qing(1636-1912 C.E.)Dynasties.In addition,the theory of epidemic disease prevention and control based on the application of“treatment in accordance with three categories of etiologic factors”was discussed to inspire and guide the prevention and treatment of COVID-19.

Lyme Borrelia as the etiological factor in three cases of primary inflammatory choriocapillaropathies

Citation： Jovanovic SV, Petrovic NT, Zivkovic MLJ, Toncic ZG, Sarenac Vulovic TS. Lyme Borrelia as the etiological factor in three cases of primary inflammatory choriocapillaropathies, lnt J Ophthalmo12017 ; 10（12）：1940-1944

Etiological Factors of Infective Endocarditis in Children Aged 1 Month to 15 Years Hospitalised in the Paediatric Department of CHU Gabriel Touréof Bamako (Mali)

Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.

Influence of environmental factors on the onset and courseof inflammatory bowel disease

Numerous environmental factors have been linked with inflammatory bowel disease. These include smoking, diet, hygiene, drugs, geographical and psychosocial factors. These factors may either increase the risk of or protect against developing this condition and can also affect the course of illness in a positive or negative manner. A number of studies have examined the influence of environmental factors on inflammatory bowel diseases as a whole as well as on ulcerative colitis and Crohn's disease separately. As there are differences in the pathogenesis of ulcerative colitis and Crohn's disease, the effect of environmental factors on their onset and course is not always similar. Some factors have shown a consistent association, while reports on others have been conflicting. In this article we discuss the current evidence on the roles of these factors on inflammatory bowel disease, both as causative/protective agents and as modifiers of disease course.

Etiological risk factors for subfertility among Palestinian women in Gaza

The inability to procreate is frequently considered a personal tragedy and a hardship for couples, impacting on the entire family and even the local community. In Gaza strip, Palestine, there has been no study on etiological risk factors for subfertility. The present study aimed to identify risk factors associated with subfertility among women in Gaza, Palestine. One hundred and sixty-nine women in the study group and 115 women in the control group were included. Cases were selected randomly from those referred to the A1 Basma Fertility Center, Gaza, Palestine. Data were collected through close-ended questionnaire, sonography, hormonal analysis and thrombophilia profile that included the methylenetetrahydrofolate reductase （MTHFR 677 C 〉 T）, factor V leiden （1691 G 〉 A） and pro- thrombin （20210 G 〉 A） genes. By using univariate analyses, the effects of different patient-related variables on the presence of subfertility were evaluated. A multiple logistic regression model was constructed, crude and adjusted odds ratios （OR） and 95% confidence intervals （95% CI） were calculated. The findings showed that 73.5 % （169/230） of the women referred to the A1 Basma Center sought treatment for subfertility. Different etiological risk factors were associated with subfertility, the most frequent of which in descending order were： thrombophilic disorders, fallopian tube problems, sex hormone abnormalities and polycystic ovary syndrome with an adjusted OR of 21.42, 13.63, 11.69 and 10.29, respectively. In conclusion, several etiological risk factors are responsible for subfertility among women in Gaza. Comprehensive evaluation of infertile women should be considered in the course of treatment; otherwise, the duration of sterility may be extended.

Breastfeeding and genetic factors in the etiology of inflammatory bowel disease in children

Inflammatory bowel disease is a chronic,debilitating disorder of the gastrointestinal tract.The etiology of inflammatory bowel disease has not been elucidated,but is thought to be multifactorial with both environmental and genetic influences.A large body of research has been conducted to elucidate the etiology of inflammatory bowel disease.This article reviews this literature,emphasizing the studies of breastfeeding and the studies of genetic factors,particularly NOD2 polymorphisms.

High Risk Factors of Pancreatic Carcinoma

Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer（PC） is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

Psychosocial factors affecting the etiology and management of type 1 diabetes mellitus:A narrative review

Type 1 diabetes(T1D)is one of the most common chronic diseases in children and adolescents worldwide.Its etiopathogenesis results from the interplay of genetic and environmental variables.Among the latter,psychological stress has been implicated in disease onset as well as disease management.Various studies,including large population-based studies,have highlighted the role of stressful life events in the etiopathogenesis of T1D.In this article,we also emphasize the importance of attachment in the early child-caregiver relationship,which can be seen as a measure of the quality of the relationship and is crucial for stress and emotional regulation.It serves as a model for all subsequent relationships in one’s life.We summarize some of the few studies performed in the field of attachment and T1D etiopathogenesis or management.T1D management demands a lifelong therapeutic regimen to prevent acute and chronic complications.In addition to psychological stress,psychological factors such as family functioning,developmental adjustment,autonomy,mental health problems and other factors have been found to relate to metabolic control.Psychological factors need to be understood not as a single directional causality-based principle but as a dynamic bi-or multidirectional system that is affected by the normal developmental transitions of childhood and adolescence.

Genetic pathways in cerebral palsy:a review of the implications for precision diagnosis and understanding disease mechanisms

Ce rebral palsy is a diagnostic term utilized to describe a group of permanent disorders affecting movement and posture.Patients with cerebral palsy are often only capable of limited activity,resulting from non-progressive disturbances in the fetal or neonatal brain.These disturbances severely impact the child’s daily life and impose a substantial economic burden on the family.Although cerebral palsy encompasses various brain injuries leading to similar clinical outcomes,the unde rstanding of its etiological pathways remains incomplete owing to its complexity and heterogeneity.This review aims to summarize the current knowledge on the genetic factors influencing cerebral palsy development.It is now widely acknowledged that genetic mutations and alterations play a pivotal role in cerebral palsy development,which can be further influenced by environmental fa ctors.Des pite continuous research endeavors,the underlying fa ctors contributing to cerebral palsy remain are still elusive.However,significant progress has been made in genetic research that has markedly enhanced our comprehension of the genetic factors underlying cerebral palsy development.Moreove r,these genetic factors have been categorized based on the identified gene mutations in patients through clinical genotyping,including thrombosis,angiogenesis,mitochondrial and oxidative phosphorylation function,neuronal migration,and cellular autophagy.Furthermore,exploring targeted genotypes holds potential for precision treatment.In conclusion,advancements in genetic research have substantially improved our understanding of the genetic causes underlying cerebral palsy.These breakthroughs have the potential to pave the way for new treatments and therapies,consequently shaping the future of cerebral palsy research and its clinical management.The investigation of cerebral palsy genetics holds the potential to significantly advance treatments and management strategies.By elucidating the underlying cellular mechanisms,we can develop to rgeted interventions to optimize outcomes.A continued collaboration between researchers and clinicians is imperative to comprehensively unravel the intricate genetic etiology of cerebral palsy.

ANALYSIS OF THE MAIN FACTORS AFFECTING SECONDARY FIBER DEINKING

The secondary fiber species,main composition of deinking agent,colloid chemistry behavior of deinking process etc. that may influence the deinking result of secondary fiber were analysed in this dissertation,and some thoughts that optimizing the currently deingking technology were also suggested.

A Pilot Study about Recurrence of Cancer： Impact ofPsychosocial Factors on Patients＇ Adjustment

The need to prevent cancer leads the authors to propose three innovative courses of cancer as categories of disease. Theobjectives of the research are to study the impact of different factors on adaptation to the recurrence of cancer and to assess the qualityof life, the anxiety as a state and the depression as a state and the evolution of the disease on a period of three months. During thislongitudinal and prospective study, the author met 32 subjects after announcing the recurrence of their cancer, and saw again 21 of them,three months later. In two times of the study, the author made fill out several questionnaires concerning various variables. The mainresults allow showing that the majority of the subjects did not present new recurrence of cancer and that the use of the Fighting spiritstrategy is representative of them. The author＇s linear regressions and the author＇s comparisons of averages allowed the authors severalrelations about to different categories of disease. Supporting therapies and management programs for stress would be beneficial for thepatients who have recurrence of their cancer.

Ambient Air Particulate PM2.5 Concentrations and Identification of Source Categories at Chihuahua, Mexico

Suspended particles in the air are pollutants formed by diverse materials and sizes. As determined in multiple studies, particulate matter equal to or less than 2.5 μrn also called breathable fraction is the one that penetrates the inferior respiratory system. The present study shows the results of a sampling campaign of particulate matter PM25 through 12 months at 3 sites： C33 （Clinic 33）, CIM （CIMAV） and A VA （Avalos） at Chihuahua, Mexico. The aim of this study was to determine the temporary concentrations of PM25, the concentration of metallic elements： Al, As, Co, Cu, Sb, Se, Fe, Mg, Mn, Ni, Pb and Zn, as well as their possible sources. The three sites had the same trend in the time, where in autumn and winter the higher concentrations were found. The yearly averages on sites C33, CIM, and AVA were 9.91, 12.74 and 21.67 μg·m^-3, respectively, finding that AVA site overpasses the standard of 15 μg·m^-3. The application of factor analysis to the data allowed to identify four source categories： crustal, related with Al-Co-Fe-Mg-Mn, vehicular, related with： As-Cu-Sb-Se; mixed, related with： As-Cu-Sb-Se-Pb-Zn and industrial related with Ni-Pb.

Risk Factors Associated with Various Subtypes of Ischemic Stroke: A Prospective Study in BSMMU, Dhaka, Bangladesh

Introduction: Stroke is the main cause of adult disability and the second most leading cause of death worldwide. The number of deaths due to stroke is 5.54 million worldwide. Globally, 70% of strokes and 87% of both stroke-related deaths and disability-adjusted life years occur in low and middle-income countries. Method: This was a prospective observational cross-sectional study conducted at Indoor, Outdoor, Stroke and Neuro-Intervention clinic of the Department of Neurology, Bangabandhu Sheikh Mujib Medical University Hospital (BSMMU), Dhaka, Bangladesh, from June-2019 to May-2020. A total of 220 ischemic stroke patients aged above 30 years confirmed by CT scan/MRI of brain. Data were collected with a pre-structured questionnaire from the patients, investigations reports and face-to-face interviews and analyzed using IBM SPSS software version 23.0. Proper consent was taken from the participants. The collected data were ANNOVA tests and association within the risk factors and the patterns of subtypes of ischemic stroke where P < 0.05 considered significant. Results: Among the 220 stroke patients, large-artery atherosclerosis (LAA), cardio-embolism (CE), small-vessel occlusion (SVO, stroke of other determined etiology (SODE) and stroke of undetermined etiology (SUDE) were being observed 84 (38.18%), 14 (6.36%), 63 (28.64%), 12 (5.45%) and 47 (18.18%). Eighty-Six (39.09%) prevalence of subtypes was found in rural areas whereas 134 (60.91%) were in urban areas. The significant risk factors are associated with the prevalence of various subtypes (p < 0.05). Conclusion: This study prevails the people of Bangladesh are vulnerable to various subtypes of ischemic stroke. The higher prevalence of large-artery atherosclerosis (LAA) in our patients suggests the presence of uncontrolled hypertension, diabetes mellitus, smoking habit and dyslipidemia.

Factors Influencing the Incidence of Heart Disease

Introduction:Understanding the causes of heart disease is a relatively new field in medicine.In fact,heart disease was relatively rare before the early 1900s.Aim:The aim of this review study is to investigate the risk factors associated with the development of heart disease and its prevention.Material Methodology:A scrutinized review of the Greek and international literature was carried out.The material of the study was manuscripts on the subject found in Greek and international electronic databases such as:Google Scholar,Mednet,PubMed and the Association of Hellenic Academic libraries(HEAL-Link).Results:The risk factors for the development of heart disease are metabolic factors,i.e.,hypertension,diabetes,cholesterol and obesity;environmental factors,i.e.,smoking,lack of physical activity or exercise,poor dietary patterns and alcohol consumption;and other factors such as age,gender,heredity,socioeconomic status and psychological factors.Conclusions:Heart diseases are multifactorial diseases and the only way to successfully treat them is to take into account all the risk factors for their development,and to treat them systematically.

Etiologies and Associated Factors of Generalised Pruritus Sine Materia in the Dermatology-Venerology Department of CHUD-Borgou/Alibori (Benin)

Introduction: The aim was to identify the etiologies of generalised pruritus sine materia and to determine the associated factors in Parakou. Methods: This was a retrospective observational study conducted from January 2011 to June 2022. The patients included were of all ages and both sexes in whom the sine materia nature of the pruritus was noted after clinical examination. These patients had an etiological assessment available or not, complete or partial. For each patient, socio-demographic, socio-cultural, socio-economic and clinical data were collected using a pre-established survey form. They were then processed and analysed using Epi Data 3.1 and SPSS version 21 software respectively. Results: The incidence of generalised pruritus sine materia was 0.89% (73 cases/8214 consultants). The predominant etiologies were aquagenic pruritus (16.4%) and intestinal parasitosis (12.3%). After a bi-variate analysis, two risk factors were identified: frequency of towel change greater than 1 month (OR = 3.02;CI95% = 0.98 - 9.31;P = 0.0486) and use of cold water for bath (OR = 3.28;CI95% = 1.09 - 9.81;P = 0.0274). Conclusion: The etiologies and associated factors of generalised pruritus sine materia found in Parakou are varied but are linked to lifestyle. There is an urgent need to raise public awareness of the need to improve lifestyle in order to reduce the frequency of pruritus sine materia. .

Biopsychosocial Review of Eating Disorders

Eating disorders are among the deadliest mental illnesses known to occur. Eating disorders directly cause 10,200 deaths each year, which is one death every 52 minutes. About 9% of the global population is affected by eating disorders at some point during their lifetime. This paper aims to provide a better understanding of the factors that contribute to the onset of eating disorders. Specifically, we examine biological factors, such as genetics, family history and the neuroscience behind eating disorders;furthermore, we explore psychological factors including other mental health conditions and their correlation, personality traits and behavioral risk factors;lastly, we consider social factors related to the onset of eating disorders, such as childhood and social environment, the media, and demographic factors.

Classification of musical hallucinations and the characters along with neural-molecular mechanisms of musical hallucinations associated with psychiatric disorders

BACKGROUND Musical hallucinations(MH)involve the false perception of music in the absence of external stimuli which links with different etiologies.The pathomechanisms of MH encompass various conditions.The etiological classification of MH is of particular importance and offers valuable insights to understand MH,and further to develop the effective treatment of MH.Over the recent decades,more MH cases have been reported,revealing newly identified medical and psychiatric causes of MH.Functional imaging studies reveal that MH activates a wide array of brain regions.An up-to-date analysis on MH,especially on MH comorbid psychiatric conditions is warranted.AIM To propose a new classification of MH;to study the age and gender differences of MH in mental disorders;and neuropathology of MH.METHODS Literatures searches were conducted using keywords such as“music hallucination,”“music hallucination and mental illness,”“music hallucination and gender difference,”and“music hallucination and psychiatric disease”in the databases of PubMed,Google Scholar,and Web of Science.MH cases were collected and categorized based on their etiologies.The t-test and ANOVA were employed(P<0.05)to compare the age differences of MH different etiological groups.Function neuroimaging studies of neural networks regulating MH and their possible molecular mechanisms were discussed.RESULTS Among the 357 yielded publications,294 MH cases were collected.The average age of MH cases was 67.9 years,with a predominance of females(66.8%females vs 33.2%males).MH was classified into eight groups based on their etiological mechanisms.Statistical analysis of MH cases indicates varying associations with psychiatric diagnoses.CONCLUSION We carried out a more comprehensive review of MH studies.For the first time according to our knowledge,we demonstrated the psychiatric conditions linked and/or associated with MH from statistical,biological and molecular point of view.

腹部外科疾病后MOF预后预测模型的建立

目的建立腹部外科疾病后多器官功能衰竭(MOF)预后预测模型。方法回顾73例腹部外科疾患后发生MOF患者的临床资料。先对存活组和死亡组的各项临床指标进行单因素分析,对单因素分析结果显示差异有统计学意义的影响因素行二值Logistic回归(强迫引入法),然后建立腹部外科疾病后MOF预后预测方程。结果休克(X1)、白蛋白值(X2)、血红蛋白值(X3)、中枢神经系统状态(X4)为预后独立危险因素。回归方程为:In(P/1-P)=β0+β1X1+β2X2+β3X3+β4X4=-4.447+1.767X1+2.047X2+1.524X3+1.209X4。其中β0=-4.447为常数项。结论成功建立了腹部外科疾病后MOF预后预测模型。

Pathophysiology of chronic pancreatitis

Chronic pancreatitis(CP)is an inflammatory disease of the pancreas characterized by progressive fibrotic destruction of the pancreatic secretory parenchyma.Despite the heterogeneity in pathogenesis and involved risk factors,processes such as necrosis/apoptosis,inflammation or duct obstruction are involved.This fibrosing process ultimately leads to progressive loss of the lobular morphology and structure of the pancreas,deformation of the large ducts and severe changes in the arrangement and composition of the islets.These conditions lead to irreversible morphological and structural changes resulting in impairment of both exocrine and endocrine functions.The prevalence of the disease is largely dependent on culture and geography.The etiological risk-factors associated with CP are multiple and involve both genetic and environmental factors.Throughout this review the M-ANNHEIM classification system will be used,comprising a detailed description of risk factors such as:alcohol-consumption,nicotineconsumption,nutritional factors,hereditary factors,efferent duct factors,immunological factors and miscellaneous and rare metabolic factors.Increased knowledge of the different etiological factors may encourage the use of further advanced diagnostic tools,which potentially will help clinicians to diagnose CP at an earlier stage.However,in view of the multi factorial disease and the complex clinical picture,it is not surprising that treatment of patients with CP is challenging and often unsuccessful.