BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected people.Eliminating mother-to-child transmission(MTCT)of HBV is at the heart of Worl...BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected people.Eliminating mother-to-child transmission(MTCT)of HBV is at the heart of World Health Organization’s goal of reducing the incidence of HBV in children to less than 0.1%by 2030.Universal screening for hepatitis B during pregnancy and neonatal vaccination are the main preventive measures.AIM To evaluate the efficacy of HBV vaccination combined with one dose of immunoglobulin in children born to hepatitis B surface antigen(HBsAg)-positive mothers in Djibouti city.METHODS We conducted a study in a prospective cohort of HBsAg-positive pregnant women and their infants.The study ran from January 2021 to May 2022,and infants were followed up to 7 mo of age.HBV serological markers and viral load in pregnant women were measured using aVidas microparticle enzyme-linked immunosorbent assay(Biomérieux,Paris,France)and the automated Amplix platform(Biosynex,Strasbourg,France).All infants received hepatitis B immunoglobulin and were vaccinated against HBV at birth.These infants were closely monitored to assess their seroprotective response and for failure of immunoprophylaxis.Simple logistic regression was also used to identify risk factors associated with immunoprophylaxis failure and poor vaccine response.All statistical analyses were performed with version 4.0.1 of the R software.RESULTS Of the 50 pregnant women recruited,the median age was 31 years,ranging from 18 years to 41 years.The MTCT rate in this cohort was 4%(2/50)in HBsAg-positive women and 67%(2/3)in hepatitis B e antigen-positive women with a viral load>200000 IU/mL.Of the 48 infants who did not fail immunoprophylaxis,8(16%)became poor responders(anti-HB<100 mIU/mL)after HBV vaccination and hepatitis B immunoglobulin,while 40(84%)infants achieved a good level of seroprotection(anti-HB>100 mIU/mL).Factors associated with this failure of immunoprophylaxis were maternal HBV DNA levels(>200000 IU/mL)and hepatitis B e antigen-positive status(odds ratio=158,95%confidence interval:5.05-4958,P<0.01).Birth weight<2500 g was associated with a poor immune response to vaccination(odds ratio=34,95%confidence interval:3.01-383.86,P<0.01).CONCLUSION Despite a failure rate of immunoprophylaxis higher than the World Health Organization target,this study showed that the combination of immunoglobulin and HBV vaccine was effective in preventing MTCT of HBV.Therefore,further studies are needed to better understand the challenges associated with immunoprophylaxis failure in infants in Djibouti city.展开更多
Experimental studies were carried out to determine the influence of solar radiation, temperatures variations, basin water amount, wind speed, glass cover thickness and salinity on the daily production of the distillat...Experimental studies were carried out to determine the influence of solar radiation, temperatures variations, basin water amount, wind speed, glass cover thickness and salinity on the daily production of the distillate output using solar desalination process, namely single slope solar still to produce fresh water from seawater in the context of Djibouti. The temperatures variations increase in relation to solar radiation. Consequently the hourly distillate output increases and reaches a maximum around noon when the solar still receives maximum intensity of solar radiation. An inverse relation is found between glass cover thickness, basin water amount and distillate output production. The variation wind speed has an effect on the daily production;which increases in relation to wind speed. In order to assess the effect of salinity on the daily production, the solar still is provided with brackish water to compare the daily production obtained from seawater. Experimental results show that the cumulative productivity decreases when there is an increase of salinity. In addition, the quality of the distillate output was tested by measuring TDS, EC, pH, hardness water and chlorides and was compared to WHO standards. The values obtained for these parameters were in accordance with the requirements of WHO and good removal efficiency for four parameters.展开更多
In this study</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> nineteen different brands of bottled mineral waters (7 brands local a...In this study</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> nineteen different brands of bottled mineral waters (7 brands local and 12 brands imported) were collected from supermarkets and independent food stores throughout Djibouti. The chemical composition mentioned on the labels of the nineteen bottled mineral waters ha</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> made the subject of a first verification by Ionic Balance Error (IBE). It was found out of the nineteen brands selected, 12 brands (2 brands local and 10 brands imported) had acceptable charge balance error. Correlation Analysis (CA), Principal Component Analysis (PCA) and Hierarchical Cluster Analysis (HCA) were used to analyze the data collected from the labels of bottled water. The obtained results showed that the 12 brands of studied waters can be grouped in 4 distinct classes with similar chemical characteristics. Two local and one imported brands have the same chemical composition but marketed under different names. It was observed that the chemical content local water brands w</span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> within the normal range prescribed by both WHO and USEPA except five imported water brands that have concentration values Ca, HCO</span><sub><span style="font-size:12px;font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">, Mg and SO</span><sub><span style="font-size:12px;font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> beyond acceptable standards. Total hardness values classified most of the studied brands from moderate to very hard water.展开更多
This work focuses on the modeling and evaluation of water resources in complex aquifer systems and the use of scarce data. The modeling work is developed based on the GLUE (Generalized Likelihood Uncertainty Estimatio...This work focuses on the modeling and evaluation of water resources in complex aquifer systems and the use of scarce data. The modeling work is developed based on the GLUE (Generalized Likelihood Uncertainty Estimation) method. This method is still little used in hydrogeology, although its applications in other disciplines such as hydrology proved quite efficient. The study site, located in the Republic of Djibouti (Horn of Africa), is represented by the volcanic massif of Goda. The hydraulic properties of this massif are highly heterogeneous since they are associated with fracturing and weathering of the geological formations. The data are too few to enable a conventional modeling approach of this volcanic system. The implementation of the GLUE method in a numerical groundwater flow model allowed developing a stochastic analysis of the spatial distribution of the hydraulic conductivity and the recharge modalities of this complex volcanic system. The hydraulic conductivities range from 10-6 to 10-8 m·s-1 for the basalt and the rhyolite formations (values are yet generally lower for rhyolites) and are higher than 5 × 10-7 for the sedimentary formations. In addition, considering diffuse recharge as the main mechanism by which the precipitation reaches the aquifer results in more consistent groundwater head simulations than considering only indirect recharge. The average recharge amount estimated for the Goda aquifer system is 28 mm·yr-1. The results led to a numerical representation of this system, with the least uncertainty. This model was able to estimate the available water resources of this system. This result is important because the Goda system supplies water to the city of Tadjourah. Assessment of available resources is vital for the future development of this city. From a methodological point of view, the GLUE method proved very promising for water resources assessment in complex hydrogeological systems for which little data are available.展开更多
CHINA and Djibouti established diplomatic relations on January 8, 1979. Located on Bab El-Mandeb Strait in the Horn of Africa, Djibouti benefits from being in a strategic geographic location. At an important transit p...CHINA and Djibouti established diplomatic relations on January 8, 1979. Located on Bab El-Mandeb Strait in the Horn of Africa, Djibouti benefits from being in a strategic geographic location. At an important transit point of the 21st Century Maritime Silk Road, Djibouti is a natural partner of China.展开更多
Amygdaloid cysts are rare cystic benign tumors due to congenital malformations resulting from an anomaly of embryonic development of the upper laterocervical region, originating from the second branchial cleft. They r...Amygdaloid cysts are rare cystic benign tumors due to congenital malformations resulting from an anomaly of embryonic development of the upper laterocervical region, originating from the second branchial cleft. They represent approximately 2% of all laterocervical tumors and 6% to 85% of anomalies of the second branchial cleft. This anomaly of the second branchial cleft is a frequent reason for consultation in the pediatric population but is relatively rare in adults. We report the cases of two patients aged 23 and 34 years with no particular pathological history. They were presenting a laterocervical swelling, one right and the other left, painless, evolving for two years for the first and for 10 years for the second, gradually increasing in volume without any other associated signs the diagnosis of which after radiological exploration (ultrasound and CT scan) was that of an amygdaloid cyst. A cervicotomy with anatomopathological examination of the surgical specimen confirmed the diagnosis of the amygdaloid cyst. The objective is to analyze the anatomo-clinical and therapeutic particularities of this pathology and to compare it with data from the literature.展开更多
Malaria is an infectious and communicable disease,caused by one or more species of Plasmodium parasites.There are five species of parasites responsible for malaria in humans,of which two,Plasmodium Falciparum and Plas...Malaria is an infectious and communicable disease,caused by one or more species of Plasmodium parasites.There are five species of parasites responsible for malaria in humans,of which two,Plasmodium Falciparum and Plasmodium Vivax,are the most dangerous.In Djibouti,the two species of Plasmodium are present in different proportions in the infected population:77%of P.Falciparum and 33%of P.Vivax.In this study we present a new mathematical model describing the temporal dynamics of Plasmodium Falciparum and Plasmodium Vivax co-infection.We focus briefly on the well posedness of this model and on the calculation of the basic reproductive numbers for the infections with each Plasmodium species that help us understand the long-term dynamics of this model(i.e.,existence and stability of various eqiuilibria).Then we use computational approaches to:(a)identify model parameters using real data on malaria infections in Djibouti;(b)illustrate the influence of different estimated parameters on the basic reproduction numbers;(c)perform global sensitivity and uncertainty analysis for the impact of various model parameters on the transient dynamics of infectious mosquitoes and infected humans,for infections with each of the Plasmodium species.The originality of this research stems from employing the FAST method and the LHS method to identify the key factors influencing the progression of the disease within the population of Djibouti.In addition,sensitivity analysis identified the most influential parameter for Falciparium and Vivax reproduction rates.Finally,the uncertainty analysis enabled us to understand the variability of certain parameters on the infected compartments.展开更多
Background: Riedel’s thyroiditis is a rare form of chronic inflammatory disease affecting the thyroid gland. It is characterised by the replacement of the thyroid parenchyma by fibrous tissue. It also affects the adj...Background: Riedel’s thyroiditis is a rare form of chronic inflammatory disease affecting the thyroid gland. It is characterised by the replacement of the thyroid parenchyma by fibrous tissue. It also affects the adjacent vital structures. Due to its characteristic presentations, Riedel’s thyroiditis may not be immediately diagnosed. Objectives: Through this clinical case, we aimed to describe the pathology and clinical characteristics of Riedel’s thyroiditis and the diagnostic, therapeutic, and progressive modalities. Methods: A 62-year-old woman with no particular pathological history is consulted at the outpatient clinic for anterior cervical swelling that has been present for more than 5 years and is associated with respiratory discomfort and dysphagia to solids. Clinical examination, ultrasound, lab tests and injected cervical computed tomography (CT) were performed. These tests were completed with pathological examination. Results: General conditions were normal. Anterior cervical swelling, marked on the right, of hard consistency, causing cervical shielding with healthy surrounding skin, was observed at the examination. A compressive goitre was first suspected. Thyroid tests showed hypothyroidism. The CT revealed a hypodense goitre with micro-calcifications developed at the expense of the right lobe and exerting a mass effect on the trachea and oesophagus. Aspiration thyroid was not conclusive given the suspicion of the malignant nature of the goitre, and the decision to perform a right loboisthmectomy was taken. Pathological examination of the biopsy showed atrophy of the thyroid parenchyma with dense septal fibrosis punctuated by lymphocytes and extending throughout the tissue associated with inflammation—an appearance in favour of Riedel’s thyroiditis. The patient was treated with Levothyroxine and corticoids. Conclusions: This case points out the challenges in diagnosing Riedel’s Thyroiditis and the complexity of the pathology that requires a rigorous diagnostic approach and appropriate treatment for the best outcome.展开更多
Djibouti,situated in the Horn of Africa,is one of the smallest coun-tries on the African continent.Arid,with scant natural resources and a high level of poverty,the country has assumed a position of strategic importan...Djibouti,situated in the Horn of Africa,is one of the smallest coun-tries on the African continent.Arid,with scant natural resources and a high level of poverty,the country has assumed a position of strategic importance in the great power contestations of the twenty-first century owing to its geographical location.Djibouti is located close to the Strait of Bab-el-Mandeb which connects the Gulf of Aden to the Red Sea and is also one of the seven choke points that are crucial to international maritime security and coun-tering cross-border terrorism.Its geographic proximity to the oil-rich Arabian Peninsula and the important shipping lane of the Gulf of Aden makes this small state a role player in great and middle-power rivalries.Host to military bases of China,the USA,Japan,France,Italy,Germany and the United Kingdom,Djibouti is also in talks with Saudi Arabia.This paper will examine the behaviour of a small state like Djibouti against the backdrop of power contestations in the geopolitically sensitive Horn of Africa.Contrary to the popular belief that small states are often com-pelled to bandwagon with the big states,the paper will attempt to make the case that states,albeit small,have agency and tools at their disposal to navigate their course through complex geopo-litical quagmires.IR theories of status-seeking and shelter will be applied to study the case of Djibouti in the context of power contestations.展开更多
India’s Horn of Africa(HoA)initiatives emerge from its evolving Africa policy,deeply rooted in historical ties,economic ventures,and global aspirations.In recent years,India has significantly inten-sified its engagem...India’s Horn of Africa(HoA)initiatives emerge from its evolving Africa policy,deeply rooted in historical ties,economic ventures,and global aspirations.In recent years,India has significantly inten-sified its engagements with African nations,placing a strong emphasis on cultivating commercial relationships,making invest-ments,and fostering development cooperation.At the heart of India’s Africa strategy lies the principle of‘South-South cooperation’(SSc),which seeks to unite developing nations in the Global South for mutual benefit and shared prosperity.India has diligently expanded its economic links with Africa,with a specific focus on trade and investment.Currently,India stands among Africa’s top investors,actively participating in sectors like infrastructure,energy,and manufacturing.Beyond economic engagement,India has emerged as a proactive partner in African development,providing support across various domains,including agriculture,education,health,and technology transfer.Moreover,India extends its hand in humanitarian and disaster relief efforts during crises.Thus,India’s HoA strategy is characterised by its multifaceted nature,leveraging historical connections with Africa and strategic influence across the Indian Ocean and the West Asia/Persian Gulf region.This is exam-ined within the context of evolving challenges in the Horn of Africa,with particular attention to the case of Djibouti.展开更多
基金Supported by the Attestation de Financement de These de Doctorat,Dakar le 28/10/2019.
文摘BACKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected people.Eliminating mother-to-child transmission(MTCT)of HBV is at the heart of World Health Organization’s goal of reducing the incidence of HBV in children to less than 0.1%by 2030.Universal screening for hepatitis B during pregnancy and neonatal vaccination are the main preventive measures.AIM To evaluate the efficacy of HBV vaccination combined with one dose of immunoglobulin in children born to hepatitis B surface antigen(HBsAg)-positive mothers in Djibouti city.METHODS We conducted a study in a prospective cohort of HBsAg-positive pregnant women and their infants.The study ran from January 2021 to May 2022,and infants were followed up to 7 mo of age.HBV serological markers and viral load in pregnant women were measured using aVidas microparticle enzyme-linked immunosorbent assay(Biomérieux,Paris,France)and the automated Amplix platform(Biosynex,Strasbourg,France).All infants received hepatitis B immunoglobulin and were vaccinated against HBV at birth.These infants were closely monitored to assess their seroprotective response and for failure of immunoprophylaxis.Simple logistic regression was also used to identify risk factors associated with immunoprophylaxis failure and poor vaccine response.All statistical analyses were performed with version 4.0.1 of the R software.RESULTS Of the 50 pregnant women recruited,the median age was 31 years,ranging from 18 years to 41 years.The MTCT rate in this cohort was 4%(2/50)in HBsAg-positive women and 67%(2/3)in hepatitis B e antigen-positive women with a viral load>200000 IU/mL.Of the 48 infants who did not fail immunoprophylaxis,8(16%)became poor responders(anti-HB<100 mIU/mL)after HBV vaccination and hepatitis B immunoglobulin,while 40(84%)infants achieved a good level of seroprotection(anti-HB>100 mIU/mL).Factors associated with this failure of immunoprophylaxis were maternal HBV DNA levels(>200000 IU/mL)and hepatitis B e antigen-positive status(odds ratio=158,95%confidence interval:5.05-4958,P<0.01).Birth weight<2500 g was associated with a poor immune response to vaccination(odds ratio=34,95%confidence interval:3.01-383.86,P<0.01).CONCLUSION Despite a failure rate of immunoprophylaxis higher than the World Health Organization target,this study showed that the combination of immunoglobulin and HBV vaccine was effective in preventing MTCT of HBV.Therefore,further studies are needed to better understand the challenges associated with immunoprophylaxis failure in infants in Djibouti city.
文摘Experimental studies were carried out to determine the influence of solar radiation, temperatures variations, basin water amount, wind speed, glass cover thickness and salinity on the daily production of the distillate output using solar desalination process, namely single slope solar still to produce fresh water from seawater in the context of Djibouti. The temperatures variations increase in relation to solar radiation. Consequently the hourly distillate output increases and reaches a maximum around noon when the solar still receives maximum intensity of solar radiation. An inverse relation is found between glass cover thickness, basin water amount and distillate output production. The variation wind speed has an effect on the daily production;which increases in relation to wind speed. In order to assess the effect of salinity on the daily production, the solar still is provided with brackish water to compare the daily production obtained from seawater. Experimental results show that the cumulative productivity decreases when there is an increase of salinity. In addition, the quality of the distillate output was tested by measuring TDS, EC, pH, hardness water and chlorides and was compared to WHO standards. The values obtained for these parameters were in accordance with the requirements of WHO and good removal efficiency for four parameters.
文摘In this study</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> nineteen different brands of bottled mineral waters (7 brands local and 12 brands imported) were collected from supermarkets and independent food stores throughout Djibouti. The chemical composition mentioned on the labels of the nineteen bottled mineral waters ha</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> made the subject of a first verification by Ionic Balance Error (IBE). It was found out of the nineteen brands selected, 12 brands (2 brands local and 10 brands imported) had acceptable charge balance error. Correlation Analysis (CA), Principal Component Analysis (PCA) and Hierarchical Cluster Analysis (HCA) were used to analyze the data collected from the labels of bottled water. The obtained results showed that the 12 brands of studied waters can be grouped in 4 distinct classes with similar chemical characteristics. Two local and one imported brands have the same chemical composition but marketed under different names. It was observed that the chemical content local water brands w</span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> within the normal range prescribed by both WHO and USEPA except five imported water brands that have concentration values Ca, HCO</span><sub><span style="font-size:12px;font-family:Verdana;">3</span></sub><span style="font-family:Verdana;">, Mg and SO</span><sub><span style="font-size:12px;font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> beyond acceptable standards. Total hardness values classified most of the studied brands from moderate to very hard water.
文摘This work focuses on the modeling and evaluation of water resources in complex aquifer systems and the use of scarce data. The modeling work is developed based on the GLUE (Generalized Likelihood Uncertainty Estimation) method. This method is still little used in hydrogeology, although its applications in other disciplines such as hydrology proved quite efficient. The study site, located in the Republic of Djibouti (Horn of Africa), is represented by the volcanic massif of Goda. The hydraulic properties of this massif are highly heterogeneous since they are associated with fracturing and weathering of the geological formations. The data are too few to enable a conventional modeling approach of this volcanic system. The implementation of the GLUE method in a numerical groundwater flow model allowed developing a stochastic analysis of the spatial distribution of the hydraulic conductivity and the recharge modalities of this complex volcanic system. The hydraulic conductivities range from 10-6 to 10-8 m·s-1 for the basalt and the rhyolite formations (values are yet generally lower for rhyolites) and are higher than 5 × 10-7 for the sedimentary formations. In addition, considering diffuse recharge as the main mechanism by which the precipitation reaches the aquifer results in more consistent groundwater head simulations than considering only indirect recharge. The average recharge amount estimated for the Goda aquifer system is 28 mm·yr-1. The results led to a numerical representation of this system, with the least uncertainty. This model was able to estimate the available water resources of this system. This result is important because the Goda system supplies water to the city of Tadjourah. Assessment of available resources is vital for the future development of this city. From a methodological point of view, the GLUE method proved very promising for water resources assessment in complex hydrogeological systems for which little data are available.
文摘CHINA and Djibouti established diplomatic relations on January 8, 1979. Located on Bab El-Mandeb Strait in the Horn of Africa, Djibouti benefits from being in a strategic geographic location. At an important transit point of the 21st Century Maritime Silk Road, Djibouti is a natural partner of China.
文摘Amygdaloid cysts are rare cystic benign tumors due to congenital malformations resulting from an anomaly of embryonic development of the upper laterocervical region, originating from the second branchial cleft. They represent approximately 2% of all laterocervical tumors and 6% to 85% of anomalies of the second branchial cleft. This anomaly of the second branchial cleft is a frequent reason for consultation in the pediatric population but is relatively rare in adults. We report the cases of two patients aged 23 and 34 years with no particular pathological history. They were presenting a laterocervical swelling, one right and the other left, painless, evolving for two years for the first and for 10 years for the second, gradually increasing in volume without any other associated signs the diagnosis of which after radiological exploration (ultrasound and CT scan) was that of an amygdaloid cyst. A cervicotomy with anatomopathological examination of the surgical specimen confirmed the diagnosis of the amygdaloid cyst. The objective is to analyze the anatomo-clinical and therapeutic particularities of this pathology and to compare it with data from the literature.
基金funded by CEALT(Centre d’Excellence Africain en Logistique et Transport)of the University of DjiboutiCEALT for their financial supportsupport from the MODCOV19 platform of the National Institute of Mathematical Sciences and their Interactions,(CNRS).
文摘Malaria is an infectious and communicable disease,caused by one or more species of Plasmodium parasites.There are five species of parasites responsible for malaria in humans,of which two,Plasmodium Falciparum and Plasmodium Vivax,are the most dangerous.In Djibouti,the two species of Plasmodium are present in different proportions in the infected population:77%of P.Falciparum and 33%of P.Vivax.In this study we present a new mathematical model describing the temporal dynamics of Plasmodium Falciparum and Plasmodium Vivax co-infection.We focus briefly on the well posedness of this model and on the calculation of the basic reproductive numbers for the infections with each Plasmodium species that help us understand the long-term dynamics of this model(i.e.,existence and stability of various eqiuilibria).Then we use computational approaches to:(a)identify model parameters using real data on malaria infections in Djibouti;(b)illustrate the influence of different estimated parameters on the basic reproduction numbers;(c)perform global sensitivity and uncertainty analysis for the impact of various model parameters on the transient dynamics of infectious mosquitoes and infected humans,for infections with each of the Plasmodium species.The originality of this research stems from employing the FAST method and the LHS method to identify the key factors influencing the progression of the disease within the population of Djibouti.In addition,sensitivity analysis identified the most influential parameter for Falciparium and Vivax reproduction rates.Finally,the uncertainty analysis enabled us to understand the variability of certain parameters on the infected compartments.
文摘Background: Riedel’s thyroiditis is a rare form of chronic inflammatory disease affecting the thyroid gland. It is characterised by the replacement of the thyroid parenchyma by fibrous tissue. It also affects the adjacent vital structures. Due to its characteristic presentations, Riedel’s thyroiditis may not be immediately diagnosed. Objectives: Through this clinical case, we aimed to describe the pathology and clinical characteristics of Riedel’s thyroiditis and the diagnostic, therapeutic, and progressive modalities. Methods: A 62-year-old woman with no particular pathological history is consulted at the outpatient clinic for anterior cervical swelling that has been present for more than 5 years and is associated with respiratory discomfort and dysphagia to solids. Clinical examination, ultrasound, lab tests and injected cervical computed tomography (CT) were performed. These tests were completed with pathological examination. Results: General conditions were normal. Anterior cervical swelling, marked on the right, of hard consistency, causing cervical shielding with healthy surrounding skin, was observed at the examination. A compressive goitre was first suspected. Thyroid tests showed hypothyroidism. The CT revealed a hypodense goitre with micro-calcifications developed at the expense of the right lobe and exerting a mass effect on the trachea and oesophagus. Aspiration thyroid was not conclusive given the suspicion of the malignant nature of the goitre, and the decision to perform a right loboisthmectomy was taken. Pathological examination of the biopsy showed atrophy of the thyroid parenchyma with dense septal fibrosis punctuated by lymphocytes and extending throughout the tissue associated with inflammation—an appearance in favour of Riedel’s thyroiditis. The patient was treated with Levothyroxine and corticoids. Conclusions: This case points out the challenges in diagnosing Riedel’s Thyroiditis and the complexity of the pathology that requires a rigorous diagnostic approach and appropriate treatment for the best outcome.
文摘Djibouti,situated in the Horn of Africa,is one of the smallest coun-tries on the African continent.Arid,with scant natural resources and a high level of poverty,the country has assumed a position of strategic importance in the great power contestations of the twenty-first century owing to its geographical location.Djibouti is located close to the Strait of Bab-el-Mandeb which connects the Gulf of Aden to the Red Sea and is also one of the seven choke points that are crucial to international maritime security and coun-tering cross-border terrorism.Its geographic proximity to the oil-rich Arabian Peninsula and the important shipping lane of the Gulf of Aden makes this small state a role player in great and middle-power rivalries.Host to military bases of China,the USA,Japan,France,Italy,Germany and the United Kingdom,Djibouti is also in talks with Saudi Arabia.This paper will examine the behaviour of a small state like Djibouti against the backdrop of power contestations in the geopolitically sensitive Horn of Africa.Contrary to the popular belief that small states are often com-pelled to bandwagon with the big states,the paper will attempt to make the case that states,albeit small,have agency and tools at their disposal to navigate their course through complex geopo-litical quagmires.IR theories of status-seeking and shelter will be applied to study the case of Djibouti in the context of power contestations.
文摘India’s Horn of Africa(HoA)initiatives emerge from its evolving Africa policy,deeply rooted in historical ties,economic ventures,and global aspirations.In recent years,India has significantly inten-sified its engagements with African nations,placing a strong emphasis on cultivating commercial relationships,making invest-ments,and fostering development cooperation.At the heart of India’s Africa strategy lies the principle of‘South-South cooperation’(SSc),which seeks to unite developing nations in the Global South for mutual benefit and shared prosperity.India has diligently expanded its economic links with Africa,with a specific focus on trade and investment.Currently,India stands among Africa’s top investors,actively participating in sectors like infrastructure,energy,and manufacturing.Beyond economic engagement,India has emerged as a proactive partner in African development,providing support across various domains,including agriculture,education,health,and technology transfer.Moreover,India extends its hand in humanitarian and disaster relief efforts during crises.Thus,India’s HoA strategy is characterised by its multifaceted nature,leveraging historical connections with Africa and strategic influence across the Indian Ocean and the West Asia/Persian Gulf region.This is exam-ined within the context of evolving challenges in the Horn of Africa,with particular attention to the case of Djibouti.
