Nasal foreign bodies in children in a pediatric hospital in Senegal: A three-year assessment

OBJECTIVES

Nasal foreign bodies (NFB) constitute a common domestic accident in children. The objectives of the present study were to report the particularities of NFBs in children presenting at a pediatric hospital in Senegal, and to describe our therapeutic attitude.

MATERIAL AND METHODS

A retrospective descriptive study included all under-15 year-olds presenting with NFB in the ENT department of the National Children's Hospital Center of Diamniadio, Senegal, between January 1, 2013 and December 31, 2015. Study variables comprised: age, gender, provenance, presenting symptoms, time to consultation, type of NFB, extraction method, and complications.

RESULTS

58 NFB cases were retrieved. Mean age was 3years 4months; 93% of patients were under 5 years old. There was female predominance of 53.45%: i.e., sex-ratio, 0.87. Location was in the right cavity in 43 patients (74.1%). The presenting symptom was purulent rhinorrhea in 51.7% of cases. Time to consultation was within 24hours in 17.24% of cases. NFB type was firstly foam rubber (29.3%), followed by grain (20.7%). Extraction was performed in consultation in 84.5% of cases and in the operating room in 15.5%. Morbidity was 22.41%: 17.24% epistaxis and 5.17% nasal infection.

CONCLUSION

NFBs constitute a common domestic accident in under-5 year-olds. The rural Senegalese context shows delay in consultation.

[Not Available]

There is a real risk of electrical accidents in the operating theatre, with the growing number of electrical, electronic and flammable liquids used. Electrocautery remains the most commonly used device for its electrosurgical effect of coagulation or tissue section. When it is defective or misplaced on a small area of the skin, it can cause a typically deep, slow healing skin burn. It adds an unexpected iatrogenic morbidity to the initial condition, with devastating consequences for the patient, the surgeon and sometimes the hospital. We report two cases of cutaneous burn by the neutral plate that occurred intraoperatively when using electrocautery in monopolar mode, and discuss etiology, clinical and prevention aspects.

Novel methods for improvement of a Penning ion source for neutron generator applications

Penning ion source performance for neutron generator applications is characterized by the atomic ion fraction and beam current density, providing two paths by which source performance can be improved for increased neutron yields. We have fabricated a Penning ion source to investigate novel methods for improving source performance, including optimization of wall materials and electrode geometry, advanced magnetic confinement, and integration of field emitter arrays for electron injection. Effects of several electrode geometries on discharge characteristics and extracted ion current were studied. Additional magnetic confinement resulted in a factor of two increase in beam current density. First results indicate unchanged proton fraction and increased beam current density due to electron injection from carbon nanofiber arrays.

Research and development of H- ion source and low energy beam transport for a kaon-neutrino factory

A baseline H(-) ion source and low energy beam transport (LEBT) system have been identified for Project X. The filament-discharge H(-) ion source has been fabricated by D-Pace, Inc. and is now in operation at LBNL. The source is capable of delivering over 10 mA of H(-) beam in cw operation with normalized 4 rms emittances less than 0.7 π mm mrad. A two-solenoid magnetic lens LEBT system has been design. The design has been validated with simulations of beam transport for 5 mA 30 keV H(-) beams using various simulation codes.

Evaluation of an Emerging Research Center: Lessons Learned

PROBLEM STATEMENT: Rigorous evaluation assures that research endeavors meet their purpose and achieve stated goals. This is especially true for federally funded exploratory research centers, which tend to be more complex due to the involvement of multiple, interdisciplinary investigators. This study provides an overview of the approach used to develop an evaluation strategy and reports the lessons learned during the initial development of the Center for Ohana Self-Management of Chronic Illness (COSMCI) at the University of Hawai'i at Mānoa School of Nursing and Dental Hygiene. The COSMCI is composed of an interdisciplinary team of researchers and practitioners and aims to advance knowledge in the field of self management of chronic disease in the community setting. APPROACH: A systematic approach was utilized that included formative and summative strategies for ongoing evaluation. The problem was solved by addressing five key concerns: (1) development of research structure, (2) observing the process of the research pilot projects, (3) scholarly activity of COSMCI faculty, (4) dissemination and translation and (5) sustainability prospects. The method of research included formulating process strategies and determine if the plans for developing the Center were followed and whether these plans were effective. Interviews were also conducted at year one and at mid-point though the project. RESULTS: Themes that emerged from our evaluation included inclusion, timelines, realistic expectations, ongoing evaluation and preparing for changes in the team. This provided timely recognition of successes and challenges and facilitated a rapid response for interventions especially during the early development stage of the center. CONCLUSION/RECOMMENDATIONS: Effective development of a successful Center is highly dependent upon having a strong evaluation process in place that can inform ongoing development. An exploratory research center requires ongoing evaluation that allows for celebration of successes, as well as early identification of problems and rapid response.

Developing a measure to evaluate a positive youth development program for Native Hawaiians: the Hui Mālama o ke Kai rubrics of Hawaiian values

OBJECTIVE

This study introduces the rubrics of Native Hawaiian values developed to measure youth knowledge and understanding of indigenous values along with 8 other tools to evaluate Hui Mālama o ke Kai (HMK), a culturally relevant, positive youth development, after-school program in a Native Hawaiian community. Findings from our efforts to validate the rubrics tool, as an evaluation measure, using triangulation are presented.

METHODS

Evaluation tools were modified through community input and measured youth risk and protective factors, including knowledge and practice of Hawaiian values. Validity and reliability of the tools were tested by analyzing internal consistency, intraclass correlations, and triangulating data sources.

RESULTS

Corroboration of results from the different data sources indicated convergent validity of measures to evaluate youth understanding and practice of Hawaiian values.

CONCLUSIONS

This community-focused approach to evaluation demonstrates how multiple evaluation instruments may reliably evaluate a program.

Multilocus sequence analysis of root nodule isolates from Lotus arabicus (Senegal), Lotus creticus, Argyrolobium uniflorum and Medicago sativa (Tunisia) and description of Ensifer numidicus sp. nov. and Ensifer garamanticus sp. nov

Nine isolates from Argyrolobium uniflorum, Lotus creticus, Medicago sativa (Tunisia) and Lotus arabicus (Senegal) were analysed by multilocus sequence analysis (MLSA) of five housekeeping genes (recA, atpD, glnA, gltA and thrC), the 16S rRNA gene and the nodulation gene nodA. Analysis of the individual and concatenated gene sequences demonstrated that the nine new strains constituted three stable, well-supported (bootstrap and gene sequence similarity values) monophyletic clusters, A, B and C, all belonging to the branch of the genus Ensifer, regardless of the phylogenetic reconstruction method used (maximum likelihood, maximum-parsimony, neighbour-joining). The three groups were further characterized by API 100 auxanographic tests, host specificity and nodA gene sequence analysis. On the basis of these data, clusters A and C are suggested as representing two novel species within the genus Ensifer, for which the names Ensifer numidicus sp. nov. (type strain ORS 1407T=LMG 24690T=CIP 109850T) and Ensifer garamanticus sp. nov. (type strain ORS 1400T=LMG 24692T=CIP 109916T) are proposed. The cluster B strains were assigned to Ensifer adhaerens genomovar A.

Radio frequency-driven proton source with a back-streaming electron dump

This article describes an rf ion source with a back-streaming electron dump. A quartz tube, brazed to a metal plug at one end, is fused in the center of a flat quartz plate. rf power (at 13.6 MHz) is coupled to generate hydrogen plasma using a planar external antenna bonded to the window. Bonding the water-cooled rf antenna to the quartz window significantly lowers its temperature. The water-cooled metal plug serves as the back-streaming electron dump. At 1800 W, the current density of extracted hydrogen ions reaches approximately 125 mA/cm(2).

[Clinical and psychopathological postpartum depression: eleven Senegalese cases report]

INTRODUCTION

The postpartum depression is a frequent puerperium psychiatric disorder. The authors study the clinical, therapeutic and evolutionary aspects of the postpartum depression among eleven Senegalese women.

MATERIAL AND METHOD

They examined the medical reports and hospital registers of eleven patients belonging to a sample of 52 women presenting psychic disorders of the puerperality. The diagnosis was made by using the International Classification of the Diseases.

RESULTS

The symptoms of depression were irritability, bad concentration, multiple somatic complaints, of insomnia of drowsiness, loss of the usual interests. All the patients profited from psychotherapy and have received chemotherapy with antidepressant treatment associated tranquillizing in six cases. They improved from 29 to 43 days after their admission.

CONCLUSION

The pregnancy and the childbirth, the parity, personal history of the patient, their social environment and the cultural representations of maternity are factors of depression of the postpartum. The antidepressant is always essential in the treatment.

[Hyperthyroidism surgery: experience of ENT department of hospital center of Thies]

INTRODUCTION

The treatment of hyperthyroidism includes different therapeutics means of which surgery. The objectives of this study were to evaluate the place of the surgery in the treatment of hyperthyroidism and to describes the complications.

PATIENTS AND METHODS

It is a retrospective study on 22 patients treated by thyroidectomy from March 2002 to April 2004. The biological confirmation was systematic. A medical preparation has been done in all the cases. A total thyroidectomy has been done in 13 cases and a subtotal in 9 cases.

RESULTS

The mean age was 37 years. There were 20 women and 2 men. An euthyroidism has obtained after surgery. There complications were: 1/22 temporary palsy of recurrent nerve 1/22 acute hypoparathyroidism 1/22 post-operative death (haematoma)

CONCLUSION

Surgery seems to be a good alternative to antithyroid agents, which are constraining and often ineffective in the long term, and to radioactive iodine who leads to a long follow-up because of induced hypothyroidy. With increasing surgical skill, the risk of recurrent or parathyroid injury is greatly decreased.

[Subdural empyema complicating acute frontal sinusitis. Four cases report]

OBJECTIVE

Subdural empyema is a collected cranioencephalic suppuration between arachnoid and dura meninge space. Subdural empyema occurring after sinusitis is an uncommon but serious complication of paranasal sinus infections. The purpose of this study is to aware the clinician about this condition. MATERIAL ET METHOD: Four young male children had been admitted with expressed fronto-ethmoid sinusitis. The intracranial infection was confirmed by computed tomography scan of brain and sinus. Both drainage of the sinus and intracranial suppuration was performed at the same time surgical procedure and antibiotics administered during 4 weeks.

RESULTS

The subdural empyema was localized in the right temporoparietal region in 1 case, in the frontal lobe in the others cases. In 1 case, the frontal subdural empyema was associated with an inerhemispherique collection. One patient underwent a second drainage. Immediate post-operative outcomes were temporally complicated with convulsions and focal neurological deficit, in 1 case. This symptoms had regressed spontaneously. There was no case of death. The functional prognosis was bad, marked by lost vision in 2 cases, which was bilateral in 1 case.

CONCLUSION

A high index of suspicion of intracranial extension of sinus infection must recommended neuroradiological investigations. When suppurative collection is confirmed, an appropriated management of the infection between otorhinolaryngologists and neurosurgeons is necessary.

[ Nodulation of certain legumes of the genus Crotalaria by the new species Methylobacterium]

We studied a collection of 126 rhizobial isolates from eight species of Crotalaria (C. comosa, C. glaucoides, C. goreensis, C. hyssopifolia, C. lathyroides, C. perrottetii, C. podocarpa, and C. retusa) growing in Senegal. Nodulation and nitrogen-fixation tests on nine Crotalaria species revealed two specificity groups within the genus Crotalaria. Group I consists of plants solely nodulated by very specific fast-growing strains. Group II plants are nodulated by slow-growing strains similar to promiscuous Bradyrhizobium spp. strains already reported to nodulate many tropical legumes. SDS-PAGE studies showed that slow-growing strains grouped with Bradyrhizobium while fast-growing strains constituted a homogeneous group distinct from all known rhizobia. Amplified ribosomal DNA restriction analysis (ARDRA) of 10 representative strains of this group using four restriction enzymes showed a single pattern for each enzyme confirming the high homogeneity of group I. The 16S rDNA sequence analysis revealed that this specific group belonged to the genus Methylobacterium, thus constituting a new branch of nodulating bacteria.

Methylotrophic Methylobacterium bacteria nodulate and fix nitrogen in symbiosis with legumes

Rhizobia described so far belong to three distinct phylogenetic branches within the alpha-2 subclass of Proteobacteria. Here we report the discovery of a fourth rhizobial branch involving bacteria of the Methylobacterium genus. Rhizobia isolated from Crotalaria legumes were assigned to a new species, "Methylobacterium nodulans," within the Methylobacterium genus on the basis of 16S ribosomal DNA analyses. We demonstrated that these rhizobia facultatively grow on methanol, which is a characteristic of Methylobacterium spp. but a unique feature among rhizobia. Genes encoding two key enzymes of methylotrophy and nodulation, the mxaF gene, encoding the alpha subunit of the methanol dehydrogenase, and the nodA gene, encoding an acyltransferase involved in Nod factor biosynthesis, were sequenced for the type strain, ORS2060. Plant tests and nodA amplification assays showed that "M. nodulans" is the only nodulating Methylobacterium sp. identified so far. Phylogenetic sequence analysis showed that "M. nodulans" NodA is closely related to Bradyrhizobium NodA, suggesting that this gene was acquired by horizontal gene transfer.

[Community nutrition strategy project: an innovation in community health]

The strategy of the community nutrition project is based on the utilization of the community development structures to deliver the nutrition services. These structures, represented in Senegal by youth associations, women groups, GIEs and NGOs, are part of the decentralization process, and as such play an important role in health and health development activities in poor urban districts. The Community Nutrition Project (CNP), funded for five years by the World Bank, German Cooperation (KFW), World Food Program (WFP) and the Senegalese government aims to halt further deterioration in the nutrition status of the most vulnerable groups in the poorest urban districts of Senegal. All nutrition services and particularly the IEC services have been entirely contracted out the first year to 76 GIEs involving 323 unemployed persons, operating as micro-enterprises "MIC" and 17 "GIEs" of unemployed physicians, pharmacists, and social workers for a total of 34 persons, organized as "maître d'Oeuvre communautaires "MOC", in charge of the supervision tasks. Each community nutrition center recruits and monitors every six months 460 to 600 beneficiaries composed of women at six months of pregnancy, lactating mother of children under 6 months, and a group of children aged from 6 to 35 months old. An average of 87% of registered children in the nutrition centers are weekly or monthly weighted. Thus the proportion of malnourished children in cohort of children followed from January to July 1996 has decreased from 70% to 25% within six months. The malnutrition rate has been reduced up to 65% after six months.

Identification of an AfsA homologue (BarX) from Streptomyces virginiae as a pleiotropic regulator controlling autoregulator biosynthesis, virginiamycin biosynthesis and virginiamycin M1 resistance

Virginiae butanolide (VB)-BarA of Streptomyces virginiae is one of the newly discovered pairs of a gamma-butyrolactone autoregulator and the corresponding receptor protein of the Streptomyces species, and has been shown to regulate the production of antibiotic virginiamycin (VM) in S. virginiae. A divergently transcribed barX gene is situated 259 bp upstream of the barA gene, and the BarX protein has been shown to be highly homologous (39.8% identity, 74. 6% similarity) to S. griseus AfsA. Although AfsA is thought to be a biosynthetic enzyme for A-factor, another member of the family of gamma-butyrolactone autoregulators, the in vivo function of S. virginiae BarX was investigated in this study by phenotypic and transcriptional comparison between wild-type S. virginiae and a barX deletion mutant. With the same growth rate as wild-type S. virginiae on both solid and liquid media, the barX mutant showed no apparent changes in its morphological behaviour, indicating that barX does not participate in morphological control in S. virginiae. However, the barX mutant became more sensitive to virginiamycin M1 than did the wild-type strain (minimum inhibitory concentration, 50 microgram ml-1 compared with > 200 microgram ml-1) and exhibited reduced VB and VM production. The VM production was not restored by exogenous addition of VB, suggesting that BarX per se is not a biosynthetic enzyme of VBs but a pleiotropic regulatory protein controlling VB biosynthesis. DNA sequencing of a 5.6 kbp downstream region of barX revealed the presence of five open reading frames (ORFs): barZ, encoding a BarB-like regulatory protein; orf2, encoding a Streptomyces coelicolor RedD-like pathway specific regulator; varM, encoding a homologue of ATP-dependent transporters for macrolide antibiotics; orf4, encoding a homologue of beta-ketoacyl ACP/CoA reductase; and orf5, encoding a homologue of dNDP-glucose dehydratase. Reverse transcription polymerase chain reaction (RT-PCR) analyses of the downstream five genes together with those of the three upstream genes (barA, barB, encoding a regulatory protein; and varS, encoding a virginiamycin S specific transporter) revealed that, in the barX mutant, the transcriptions of barZ, orf2, varM and orf5 were completely repressed and those of barB and varS were derepressed. Because free BarA (BarA in the absence of VB) in wild-type S. virginiae represses the transcription of bicistronic barB-varS operon through binding to a specific DNA sequence (BarA-responsive element, BARE) overlapping the barB transcriptional start site, the derepression of barB-varS transcription in the barX mutant suggested that the in vivo function of BarA was impaired by the lack of BarX protein. Gel-shift assays revealed that BarA easily lost its DNA-binding activity in the absence of BarX but that the defect was restored by the presence of recombinant BarX as a fusion with maltose-binding protein (MBP-BarX), whereas MBP-BarX itself showed no DNA-binding activity, indicating that BarX is likely to be a co-repressor of BarA, enforcing the DNA-binding activity of BarA through protein-protein interactions.

[Vitamin e supplementation in Senegalese children with kwashiorkor]

Kwashiorkor continues to be a major cause of infant mortality in the developing world. It has recently been suggesting that this form of malnutrition is due to oxidizing aggression. Vitamin E is a powerful natural anti-oxidant, and we therefore investigated the extent to which its supplementation in the diet contributed to treating child kwashiorkor. Vitamin E was also administered to children suffering from marasmus. The study was conducted from October 1993 to July 1994 and included 79 children (38 cases of kwashiorkor and 41 of marasmus). The treatment resulted in a 76% success rate, with the best results for marasmus (89.5% cure). However, the supplement did not have any effect on the nutritional status for either the kwashiorkor or marasmus patients. In the kwashiorkor group, the weight increase, after disappearance of edema was 15.2 +/- 4.9 g/kg/d in the supplemented group as compared to 16.4 +/- 3.6 g/kg/d in the control group. The duration of edema along treatment was similar for the two groups (supplemented: 8.6 +/- 3.1 days, control group: 7.1 +/- 3.9 days). Possible reasons for vitamin E supplementation having no effect are discussed.

[Complementary nutrition for the young child following the devaluation of the CFA franc (African Financial Community): 2 case studies in the Congo and Senegal urban environment]

Developing countries frequently see their currency depreciated to varying degrees. The consequences of such monetary disturbances on the nutrition of young children are not well known, though children are the most vulnerable in nutritional terms. One year after the 50% devaluation of the CFA Franc (communauté financière africaine, "African Financial Community"), which took place on 12 January 1994 simultaneously in fourteen countries, nine of which are on the UNDP list of least developed countries, we wanted to find out the long-term effects of the devaluation, and the strategies that families had adopted to cope with it. In Brazzaville, Congo, in December 1994, an epidemiological survey was conducted on a representative sample of 893 children between the ages of 4 and 12 months in two districts, and indicators of child nutrition were established. A comparable survey had been conducted in December 1993, before the devaluation. In Senegal, in the absence of a previous survey which could be used in comparison, a qualitative survey using RAP methodology, was conducted in January 1995 in two towns near the capital. In three districts in each of these towns, a cluster of ten plots was chosen at random and surveyed, with a combination of semi-structured individual interviews with mothers (n = 60) and group interviews with all the women together (n = 6). The information was put together with interviews of 25 local traders selling food. In the Congo, comparison of the two surveys shows that the practice of breast-feeding had hardly changed, nor had the age at which baby food was introduced (90% of children of 4-5 months take semi-solid and solid foods); on the other hand, more children are being given the ordinary family meal earlier, at 6-9 months. The proportion of baby foods based on commercially imported flour has fallen (from 32% in 1993 to 18% in 1994), and has been replaced with local products based on maize; this change is more marked among poorer families. The low nutritional value of such preparations is in part compensated by the addition of sugar, though less milk is added (28% in 1994 as opposed to 43% in 1993). In Senegal, mothers do not seem to have changed their breast-feeding practices either, the age at which baby foods are introduced, or the number of times they are provided daily. The most important change is the drop in quality of food given to children, and the poorer family food for the older children. The partial switch from imported products to local produce was an expected consequence of devaluation; it is clearly confirmed here for nutrition of young children, with the consequent loss of nutritional quality (a reduction in energy density and in nutrients). The first thing needed is, therefore, an improvement in local manufacture of food supplements of good nutritional quality, for young children. Mothers also complain of the increased difficulty in managing a family diet so as to take account of economic needs, cultural values and nutrition. They therefore criticize a number of nutritional education messages that are clearly no longer appropriate to the new economic context. Finally the fact that young children are getting poorer quality nutrition is worrying for the future: if it lasts, the nutritional status of children will deteriorate; whenever possible, monitoring must be established so that measures can be taken when necessary to forestall any dramatic deterioration that would endanger the health of the children.