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.

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. .

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.

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.

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.

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.

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.

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.

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.

基于DLPP-LOF的信息物理系统异常诊断方法

为了准确诊断信息物理系统的异常类型,提出了一种新的基于动态局部保持投影-局部离群因子(dynamic locality preserving projections-local outlier factor,DLPP-LOF)的方法。首先,采用数据增广策略在判别模型中考虑自相关性,进而利用对数据分布没有要求的流形学习方法——局部保持投影(locality preserving projections,LPP)提取特征。其次,计算测试数据特征相对于训练数据集各类别特征的局部离群因子(local outlier factor,LOF),将具有最小离群因子的类作为测试数据的类别。确定了异常类别后,在已建立的历史异常数据及相应决策方案库中搜索制定应急响应预案。最后,将所提出的DLPP-LOF方法在典型信息物理系统上进行测试,验证了其有效性及优越性。

Prevalence of type 2 diabetes mellitus in the pediatric population of a third-level care hospital in Mexico City in 2013 and 2018

BACKGROUND Diabetes mellitus type 2(T2DM)is a state of hyperglycemia due to a defect in the secretion and/or action of insulin,and it represents the most common form of diabetes worldwide.In Mexico,10.3%of the adult population have been diagnosed with T2DM and it is expanding to the pediatric population.AIM To evaluate and compare the prevalence of T2DM in the pediatric population at the Children’s Hospital,“Hospital Infantil de México Federico Gómez(HIMFG)”,at two time periods:2013 vs 2018.METHODS A comparison of two cross-sectional studies was done(2013 and 2018).The study population was comprised of children and adolescents 8-17 years old,from the Diabetes Clinic at the aforementioned institution.A comprehensive interrogation regarding family history and perinatal antecedents was performed.Complete blood work after 12 h of fasting was obtained to determine serum levels of glucose,glycated hemoglobin,lipid profile,C-peptide,and insulin.The data were analysed using the statistical software package SPSS v.23.0.A P value of<0.05 was considered statistically significant.RESULTS A total of 151 patients were included:47 from 2013,and 104 from 2018.There were age differences noted between the two periods with younger patients presenting T2DM in 2013.Also,T2DM predominated in the male sex in 55.36%in 2013 vs 32.7%in 2018.An increased prevalence of T2DM was noted from 2013 to 2018(20.2%vs 33.0%,respectively),which was a statistically significant 12.8%increase(P<0.0001).The illness phenotype was more aggressive in the 2018 group with the presence of a higher proportion of obesity,insulin resistance,and adverse lipid profiles.CONCLUSION The prevalence of T2DM at the HIMFG institution from 2013 to 2018 increased by 12.8%(20.2%vs 33.0%,respectively).The study results demonstrate the need for vigilance in T2DM trends,and to strengthen programs of healthy nutrition and physical activity as well as early detection and risk factors for obesity,data on insulin resistance,and metabolic syndrome,with the aim of preventing the development of T2DM.

基于“三因四证”调整免疫炎症状态的中医药治疗心血管疾病研究述评

动脉粥样硬化是心血管疾病发生发展的重要病理基础,物质代谢异常和免疫炎症反应是其发生发展的重要原因,由此导致的免疫炎症状态贯穿其病理始终。本文以“病”(心力衰竭)为切入点,结合心脉相关理论,总结气、血、水“三因”病机与免疫炎症状态的相关性。心气、心血、心水异常可出现在心力衰竭的不同阶段,持续的免疫炎症状态贯穿心力衰竭始终。同时,岭南地区常年湿热的气候环境因素及人群气虚、阳虚和湿热体质与免疫炎症状态发生密切相关,“积湿生热”及“湿自热生”的湿热相互转化机制使得岭南地区心血管疾病的病机以气虚痰浊夹瘀多见。在此基础上,痰、瘀、湿、热等伏匿机体的多种病理产物在疾病发展过程中累积,久酿而成内生伏毒,由此总结性归纳将痰、瘀、湿、毒“四证”与免疫炎症状态紧密联系。本文用“病—证—治”关联视角探讨中医药防治心血管疾病,融合治未病思想,从理论到应用,从基础到临床,以期为进一步制定和实施中医药诊疗方案提供理论指导。