Background: Artificial intelligence (AI) has the potential to transform medical diagnostics by enhancing the accuracy and efficiency of diagnostic processes. Its application in clinical practice can greatly support me...Background: Artificial intelligence (AI) has the potential to transform medical diagnostics by enhancing the accuracy and efficiency of diagnostic processes. Its application in clinical practice can greatly support medical professionals by offering improved tools for faster and more precise diagnoses. Understanding AI’s capabilities is essential for its successful integration into medical diagnostics. In this context, evaluating the performance of different AI models in the diagnostic process becomes particularly important. The objective of this study is to qualitatively evaluate the diagnostic performance of three AI models—ChatGPT-4o, CodyMD, and Dr. Gupta—based on patient-reported symptoms. Objectives: The aim of the study is to compare the three AI models in terms of diagnostic accuracy, the level of detail in the provided information, the interaction between the models and patients, and the number of differential diagnoses offered. Results: ChatGPT-4o achieved the highest accuracy, correctly diagnosing 90% of the cases. The model provides basic information and focuses on a single most likely diagnosis. CodyMD and Dr. Gupta achieved 50% accuracy, with CodyMD using an interactive approach and offering differential diagnoses with probability percentages for each. Dr. Gupta provided educational medical information and differential diagnoses without probability estimates. Conclusions: The AI models assessed can assist medical professionals in the diagnostic process, but they require further refinement and optimization. ChatGPT-4o stands out for its high accuracy, though increased patient interaction is needed. CodyMD excels in offering an interactive approach and more detailed responses, but requires improved accuracy. Dr. Gupta provided differential diagnoses, but the information provided is suitable for educational purposes. While these models show potential for clinical use, further research is needed to optimize and validate them in real-world settings.展开更多
Streptococcus mitis （S. mitis） is a pioneer commensal bacterial species colonizing many of the surfaces of the oral cavity in healthy individuals. Yet, not much information is available regarding its interaction wit...Streptococcus mitis （S. mitis） is a pioneer commensal bacterial species colonizing many of the surfaces of the oral cavity in healthy individuals. Yet, not much information is available regarding its interaction with the host. We used examination of its transcriptional regulation in oral keratinocytes to elucidate some of its potential roles in the oral cavity. Transcription factor analysis of oral keratinocytes predicted S. mitis.mediated activation of aryl hydrocarbon receptor （AhR）, Activation and functionality of AhR was confirmed through nuclear translocation determined by immunofluorescence microscopy and real-time polymerase chain reaction with reverse transcription analysis of CYPIA1, the hallmark gene for AhR activation. Addition of Streptococcus mutans or Streptococcus gordonfi did not induce CYPIA1 transcription in the keratinocyte cultures. Introduction of an AhR-specific inhibitor revealed that S. mitis-mediated transcription of CXCL2 and CXCL8 was regulated by AhR. Elevated levels of pmstaglandin E2 （enzyme-linked immunosorbent assay） in supernatants from S. mitis-treated oral epithelial cells were also attenuated by inhibition of AhR activity. The observed AhR-regulated activities point to a contribution of S. mitis in the regulation of inflammatory responses and thereby to wound healing in the oral cavity. The concept that the oral commensal microbiota can induce AhR activation is important, also in view of the role that AhR has in modulation of T-cell differentiation and as an anti-inflammatory factor in macrophaees.展开更多
Coronary cameral fistula (CCF) is a very rare coronary anomaly in which a communication exists between one of the coronaries and a cardiac chamber. Most of the times it is an incidental finding detected at the time of...Coronary cameral fistula (CCF) is a very rare coronary anomaly in which a communication exists between one of the coronaries and a cardiac chamber. Most of the times it is an incidental finding detected at the time of a coronary angiography. However, sometimes it can have serious presentation like unstable angina, coronary steal or ventricular arrhythmia. We present a rare case of coronary cameral fistula arising from left circumflex artery (LCx) draining in to left ventricular (LV) apex and presenting as unstable angina.展开更多
The aim of this study was to develop a simple and derivatization free method for the Quantification of S-Epichlorohydrin in R-Epichlorohydrin by using a gas chromatography coupled with flame ionization detector (FID)....The aim of this study was to develop a simple and derivatization free method for the Quantification of S-Epichlorohydrin in R-Epichlorohydrin by using a gas chromatography coupled with flame ionization detector (FID). Enantiopure epichlorohydrin was a valuable epoxide key starting material for preparing optically active Rivaroxaban. The enantiomeric separations of S-Epichlorohydrin and R-Epichlorohydrin were achieved on Gamaa-Dex-225 (30 meters × 0.25 mm I.D, 0.25 μm) column with a total run time of 30 min. Nitrogen was used as a carrier gas with constant pressure 25.0 psi. The critical experimental parameters such as, column selection, flow rate, injection volume and diluent were studied and optimized. Excellent correlation coeffient between peak responses and concentrations was >0.9998. The recoveries of S-Epichlorohydrin spiked in R-Epichlorohydrin were in the range from 98.2% to 102.8%. Limit of quantitation for S-Epichlorohydrin was sufficiently lower than limits specified by ICH. The method has validated as per International Conference on Harmonization (ICH) guidelines. A precise, accurate, linear and robust Gas Chromatography method was developed for the quantification of S-Epichlorohydrin in R-Epichlorohydrin for Rivaroxaban.展开更多
Objective: To describe and analyze the epidemiological aspects as well as the observance of post-exposure prophylaxis (PEP) of people bitten by a dog and received at the Buanionzi State Health Center from 2014 to 2017...Objective: To describe and analyze the epidemiological aspects as well as the observance of post-exposure prophylaxis (PEP) of people bitten by a dog and received at the Buanionzi State Health Center from 2014 to 2017. Methods: Descriptive cross-sectional study which took place in two stages. The first interview was an interrogation carried out at the health Center until surgical trimming (100% of cases) followed by PEP (70.3% of cases) according to the Essen protocol. The second time was a 24 h telephone interview after a missed appointment for a dose of PEP. Results: The prevalence was 5.6 bites/10.000 people. The average age was 26.4 ± 18.3 years. Age ≤ 26 years was more concerned with 59.3% of cases (p = 0.006) in which children Conclusion: The rabies risk is potential in Boma. Efforts in terms of public health strategies must be made to reduce it.展开更多
Breast milk is important for infant health. Some of its benefits are due to the presence of a specific population of bacteria in the microflora. However, the microbiome of breast milk is influenced by many parameters ...Breast milk is important for infant health. Some of its benefits are due to the presence of a specific population of bacteria in the microflora. However, the microbiome of breast milk is influenced by many parameters such as maternal diet, breastfeeding and geographic location. Culture and non-culture methods have been used in studies of this bacterial population worldwide. But in the DR Congo, there was no study reporting the use of culture-independent techniques to characterize the bacterial diversity of human milk. The aim of this study was to identify the bacterial 16S rRNA gene from two genera Lactobacillus and Bifidobacterium. The 16S rRNA gene was also identified from four species: Lactobacillus reuteri, Lactobacillus rhamnosus, Bifidobacterium longum and Bifidobacterium lactis. This analytical cross-sectional study was conducted in Kinshasa. Breast milk from some healthy women was collected from February 2 to 28, 2018. A culture-independent protocol using the classical polymerase chain reaction (PCR) was used to identify the bacterial 16S rRNA gene. The 68 samples of breast milk were collected in a sterile condition. The bacteria-specific ribosomal gene 16S rRNA was detected in 91.18% of Lactobacillus and 32.35% of Bifidobacterium at genus level. At of species level, only Lactobacillus reuteri 16S rRNA gene was identified in 89.71%. The 16S rRNA gene from the other species could not be amplified. There was also an association between educational level and the presence of Bifidobacterium and Lactobacillus 16S rRNA genes in the breast milk (p = 0.008*, p Conclusion: This study demonstrates the presence of the bacterial 16S rRNA gene from Lactobacillus and Bifidobacterium in breast milk at the genus and Lactobacillus reuteri at species level. A further study on the diet, use of antibiotics during pregnancy and lactation practice will provide a better understanding of the microflora of breast milk.展开更多
The Makiso municipality is located in an urban area influenced by a very high rate of land occupation by houses. This land use has an impact on the quality of the groundwater exploited by wells and springs. This groun...The Makiso municipality is located in an urban area influenced by a very high rate of land occupation by houses. This land use has an impact on the quality of the groundwater exploited by wells and springs. This groundwater helps to make up for the deficit caused by the lack of a water distribution network. It is also threatened by pollution from human activities. In order to protect the groundwater in Makiso municipality from pollution, the study of the intrinsic vulnerability assessment in the aquifers was carried out by applying the DRASTIC method and the Geographic Information System (GIS). The results obtained using this method were grouped into two degrees of vulnerability (medium and high), with variations in DRASTIC indices of [141 - 145] for the medium degree and [146 - 175] for the high degree. The high vulnerability class is the most dominant, with a percentage of 96.5% of the study area. The medium vulnerability class, which represents 3.5% of the area of the Makiso municipality, is mainly located in the western (medical plateau district), central (Lualaba district) and southern (commercial district) sectors in the form of isolated pockets. A comparison of the nitrate distribution map with the final vulnerability map shows that the areas defined as highly vulnerable by the DRASTIC method and the areas with high nitrate concentrations (above 0.11 mg/l) are in agreement. On the other hand, there are other areas with low nitrate concentrations (below 0.05 mg/l) which correspond to the high vulnerability indices.展开更多
This work presents a study of the Paleogene sandstones of the Manika plateau in Kolwezi, DR Congo. These sandstones belong to the “Grès polymorphes” group, which together with the overlying “Sables ocre” make...This work presents a study of the Paleogene sandstones of the Manika plateau in Kolwezi, DR Congo. These sandstones belong to the “Grès polymorphes” group, which together with the overlying “Sables ocre” makes up the Kalahari Supergroup. Sedimentological and geochemical analyses have enabled us to characterize these sandstones and determine their origin, the conditions of their formation and the tectonic context in which they were developed. The results show that the sandstones are quartz arenites with a high level of mineralogical, textural and chemical maturity. They are recycled sandstones, formed in an intracratonic sedimentary basin, in the context of a passive continental margin, after a long fluvial transport of sediments. These sandstones initially come from intense alteration of magmatic rocks with felsic composition, mainly tonalite-trondhjemite-granodiorite (TTG) complexes, in hot, humid palaeoclimatic conditions and oxidizing environments.展开更多
Some diseases require medical mitigation following the diagnosis, and sometimes the situation means that the patient has to undertake strong medication. However, this medicine is designed pharmacodynamically to intera...Some diseases require medical mitigation following the diagnosis, and sometimes the situation means that the patient has to undertake strong medication. However, this medicine is designed pharmacodynamically to interact with other organs before they reach the intended organ. Some mitigation imposes challenges on the involved organ. While the main organ will be healed, some drugs’ footprints will be left out to other organs. These are called iatrogenic injuries. In the case of anastomosis, it requires the alteration of surgical methods or the origin of iatrogenic injury in the arm;thus, the knowledge of anastomosis is very important to the field of medical practice. In addition, carpal tunnel release becomes vital in curing carpal tunnel syndrome. The paper focuses on a case of a 42-year-old woman found to have a complication to her middle finger. This case becomes important for studying Berrettini anastomosis iatrogenic injury, which relates to carpal tunnel syndrome. The Berrettini branch is a complication that facilitates communication between the superficial ulnar and median nerve. The analysis also provides the electro-diagnostic evidence of Berrettini anastomosis on how it can give a position three-finger and thus contribute to a force explanation of the median neuropraxia. Lastly, the paper provides information on the implication of the Berrettini branch for surgical use. The implication of pictures in the digital era can be used to analyze the varied connection and length between the median nerve and ulnar section. It’s easy to locate the position of high risk of iatrogenic injury in the palm due to the consistent location of Berrettini communication branches. The precaution is that operations have to be conducted moderately for a clear vision as the carefully mitigated practice ensures protection from the destruction and injury of the surrounding structures.展开更多
<span style="font-family:Verdana;">The “Axillary web syndrome” (AWS) is an early complication following breast cancer surgery with axillary lymph nodes dissection. <strong>Case Report:</stro...<span style="font-family:Verdana;">The “Axillary web syndrome” (AWS) is an early complication following breast cancer surgery with axillary lymph nodes dissection. <strong>Case Report:</strong> The patient is a 69-year-old woman, retired ex-employee, with outcome surgery right axillary lymphadenectomy with shoulder pain and functional limitation with diagnosis AWS it where it was recommended the physiotherapy. The patient had improvement in terms of shoulder function and pain and quality of life. <strong>Conclusions:</strong> The description of the clinical case afflicted with AWS and the treatment protocol applied, highlighted the good performance of the results, notably as concerns patient’s quality of life. This result could represent a starting point for creating clinical trials aimed at building appropriate rehabilitation route in territorial rehabilitation services.</span>展开更多
Environmental change is characterized as an alteration in the environment caused primarily by human activities and ecological processes that are natural. Given the fact that the southern part of the province of Haut-K...Environmental change is characterized as an alteration in the environment caused primarily by human activities and ecological processes that are natural. Given the fact that the southern part of the province of Haut-Katanga in the Democratic Republic of the Congo (DRC) is part of the African Copperbelt and has been a region of intense mining for decades, humans have affected the physical environment in various ways: such as overpopulation, suburbanization, wastage, deforestation. It is therefore important to track and control the changes in the area’s mining activities. This study aimed to analyze these changes using remote sensing techniques. Landsat satellite images from 2002 and 2022 were processed and classified to quantify changes in built-up area, agricultural land, and vegetation cover over the 20-year period. The classification results revealed sizable differences between the two time points, indicating considerable expansion of built-up land and declines in agricultural land and vegetation cover from 2002 to 2022 in Likasi. These findings provide evidence that urban growth has transformed the landscape in Likasi, likely at the expense of farmland and ecosystems. Further analysis of the remote sensing data could quantify the changes and model future trends to support sustainable land use planning. The land cover and land use analysis were performed with the assistance of the ERDAS 16.6.13 software by mapping LANDSAT data from two different years 2002 and 2022.展开更多
Ordinary Portland Cement (OPC) is by mass the largest manufactured product on Earth, responsible for approximately 6% - 8% of global anthropogenic carbon dioxide emissions (CO<sub>2</sub>) and 35% of indus...Ordinary Portland Cement (OPC) is by mass the largest manufactured product on Earth, responsible for approximately 6% - 8% of global anthropogenic carbon dioxide emissions (CO<sub>2</sub>) and 35% of industrial CO<sub>2</sub> emissions. On average 0.8 to 0.9 ton of CO<sub>2</sub> is emitted to produce one ton of OPC. In this paper, partial substitution of clinker (30% - 35%) by the calcined clay-limestone mixture was investigated in order to produce an eco-cement (LC3). Analyzes by XRF, XRD and ATG/ATD have characterized different components, determined the calcination temperature and selected the right clay which can act as effective Supplementary Cementitious Material (SCM). Mechanical tests on mortar carried out over a period of 90 days. The WBCSD/WRI “Greenhouse Gas Protocol” methodology then allowed the calculation of CO<sub>2</sub> emissions into the atmosphere. Three types of clay are available in the Songololo Region. The kaolinite is the principal clay mineral and its content varies from 27% to 34%. The sum of kaolinite and amorphous phase which enable clay to react with cementitious material ranges from 57% to 60%. The SiO<sub>2</sub> content ranges from 33% to 76%, the Alumina content from 12% to 20% so that the ratio Al<sub>2</sub>O<sub>3</sub>/SiO<sub>2</sub> is on the higher side (0.17 - 0.53). The calcination window is between 750°C and 850°C and the best clay which can act as SCM identified. The clinker’s substitution reduced CO<sub>2</sub> emissions from 0.824 ton of CO<sub>2</sub> for one ton of OPC to 0.640 ton of CO<sub>2</sub> for one ton of LC3, means 22% less emissions. The compressive strengths developed by LC3 vary from 8.91 to 57.6 MPa (Day 1 to Day 90), exceed those of references 32.5 cement and are close to 42.5 cement. In view of the results, LC3 cement can be considered for industrial trials.展开更多
Hydrological modeling plays a crucial role in efficiently managing water resources and understanding the hydrologic behavior of watersheds. This study aims to simulate daily streamflow in the Godavari River Basin in M...Hydrological modeling plays a crucial role in efficiently managing water resources and understanding the hydrologic behavior of watersheds. This study aims to simulate daily streamflow in the Godavari River Basin in Maharashtra using the Soil and Water Assessment Tool (SWAT). SWAT is a process-based hydrological model used to predict water balance components, sediment levels, and nutrient contamination. In this research, we used integrated remote sensing and GIS data, including Digital Elevation Models (DEM), land use and land cover (LULC) maps, soil maps, and observed precipitation and temperature data, as input for developing the SWAT model to assess surface runoff in this large river basin. The Godavari River Basin under study was divided into 25 sub-basins, comprising 151 hydrological response units categorized by unique land cover, soil, and slope characteristics using the SWAT model. The model was calibrated and validated against observed runoff data for two time periods: 2003-2006 and 2007-2010 respectively. Model performance was assessed using the Nash-Sutcliffe efficiency (NSE) and the coefficient of determination (R2). The results show the effectiveness of the SWAT2012 model, with R2 value of 0.84 during calibration and 0.86 during validation. NSE values also ranged from 0.84 during calibration to 0.85 during validation. These findings enhance our understanding of surface runoff dynamics in the Godavari River Basin under study and highlight the suit-ability of the SWAT model for this region.展开更多
Zatua Hills are located at Haut Uélé Province of Democratic Republic of Congo (DRC), between northern Bafwasende and southern Paulis (Isiro) Squarred Degrees. Belonging to greenstone belt of Ngayu, that area...Zatua Hills are located at Haut Uélé Province of Democratic Republic of Congo (DRC), between northern Bafwasende and southern Paulis (Isiro) Squarred Degrees. Belonging to greenstone belt of Ngayu, that area is identified by the high elevated zone which is remained the witness of stable zone, not affected by the ancienst erosion process. Zatua Hills are in the superior Kibalian formation dated to Neoarchaen, hosted in Upper Congo Granites Massifs of DRC covering a large central zone of NE of DRC, and consisting to dolerite, phyllade, clay rich sediment, poor Banded Iron Formations (BIFs), enriched BIFs, friable hematite, hard hematite, mineralized and unmineralized brechias. Magnetite, martite and hematite are associated to some secondary minerals such as goethite, gibbsite, kaolinite, strengite, variscite and others clay minerals present in BIFs. Petrographic analysis made from the samples collected in situ showed, as well as BIFs and iron ore associated, that magnetite was much abundant oxide mineral which is oxided to martite before to stabilize to hematite during the deposition time. Having about hundred meters of thickness, the rich iron ore of this area content, in the majority less deleterious elements which, are harmful in metallurgic process of iron. These secondary minerals were precipitated at various degrees in the leached cavities of rocks between martite and hematite aggregates to botryoidal texture and, are rich to Al, and are mainly consisting to gibbsite and solid solution series of variscite-strengite (AlPO<sub>4</sub>·2H<sub>2</sub>O and FePO<sub>4</sub>·2H<sub>2</sub>O). Low degree of metamorphism played when magnetite was converted to martite, with the presence of variscite and anatase like witnesses of this event in which, martite was crystalized to hematite.展开更多
Rapid and uncontrolled urbanization as well as urban land management are major constraints to land planning in the Democratic Republic of Congo. A household data collection and analysis was carried out in 283 random h...Rapid and uncontrolled urbanization as well as urban land management are major constraints to land planning in the Democratic Republic of Congo. A household data collection and analysis was carried out in 283 random households in the Nkafu municipality, eastern DR Congo, to assess the local community’s perception of rapid urbanization and its impact on land policy and management of the built landscape. Data of socio-demographics characteristics, rapid urbanization, and environment management data were collected and analyzed using XLStat version 2019. In addition, the study area location map, land use and cover change maps were generated using ArcMap 10.8. Results indicate that landowners are dominant and, build simple houses with unsustainable building materials (i.e. wooden plank) obtained locally. In addition, land management is not appreciated by local communities, due to anarchic construction due to lack of financial resources generating thus an increasing amount of urban waste, which is poorly managed. The study suggests, urban roads renew, building in conformity with urban planning and building regulations, potable water supply and health services availability to improve the study area. Geographic Information Systems (GIS) use, would provide spatial information on land planning in the study area.展开更多
Zatua Hills are located in the northeastern part of the DR Congo in Haut Uélé Province, formerly known as Province Orientale. This part of DR Congo is identified by the high elevated zone, which has rem...Zatua Hills are located in the northeastern part of the DR Congo in Haut Uélé Province, formerly known as Province Orientale. This part of DR Congo is identified by the high elevated zone, which has remained a witness to a stable zone not affected by the ancient erosion process. BIFs are most abundant and are dated to the Neoarchaean and Late Kibalian, hosted in the Upper Congo Granites Massifs of the DR. Congo. Zatua Hills consist of dolerite, phyllade, clay-rich sediment, poor itabirite, enriched BIFs, friable hematite, hard hematite, and mineralized and unmineralized breccias. Field study and geochemistry analysis by XRF, XRD, and ICP-MS are executed in order to know the geochemistry signature and paragenesis of Zatua Hills and the probably process could lead the BIFs to iron ore. The geochemistry analysis by XRF, XRD, and ICP-MS shows that Iron ore content has an iron rate between 57% and 69% with less deleterious elements such as Si, P, and Al. These deleterious elements are secondary and have silicium composition (probably quartz or chert, goethite, and Kaolinite), aluminum (probably gibbsite, variscite, cadwaladérite, goethite, and Kaolinite), phosphorous (probably variscite), and hydrated minerals, which are grown LOI in the samples. Hypogen and supergen processes are played in BIFs for iron ore conversion and, respectively, silica dissolution and leaching. Metamorphism was also impacted and marked by the Ti element (anatase) in samples, contributing to the crystallization of martite to hematite after magnetite oxidation.展开更多
Background: It appeared that the conjunction inflammation and nerve damage (caused by surgery) generate the hyperalgesic component. But the probability of predicting hyperalgesia from the size of the surgical incision...Background: It appeared that the conjunction inflammation and nerve damage (caused by surgery) generate the hyperalgesic component. But the probability of predicting hyperalgesia from the size of the surgical incision and/or the resulting inflammatory reaction is not well elucidated. This survey aims to study the influence of the size of the surgical incision and the resulting inflammatory reaction (interleukin 6 levels) in the occurrence of postoperative hyperalgesia in the population of Lubumbashi. Methods: The present study was descriptive cross-sectional. The data collection was prospective over 5 months, from February 1, 2024 to June 30, 2024. This study included any patient over the age of 18 who underwent surgery under general anesthesia. We used indirect signs to define hyperalgesia: higher (ENS > 6) and prolonged pain, postoperative overconsumption of morphine. Results: During our survey, we collected 48 operated patients who had severe postoperative pain, 16 of whom had hyperalgesia, i.e. a prevalence of hyperalgesia of 33.33%. The size of the incision most represented was between ≥20 and i.e. 62.50%. The type of surgery most affected by hyperalgesia was laparotomy. We observed an elevation of IL6 in 87.50% of patients. The largest elevation was 8.91 times the preoperative value and the smallest was 1.04 times. Pre- and postoperative IL6 levels were not associated with hyperalgesia (p = 0.265). Only the size of the surgical incision was associated with hyperalgesia (p = 0.04). Incision size values between [20 - 30] cm were those associated with hyperalgesia (p = 0.027). The model shows that making an incision greater than or equal to 20 cm increases the patient’s risk of developing hyperalgesia by more than 7.222 times and this is statistically significant (p = 0.004). Conclusion: According to this survey, the size of the surgical incision was associated with postoperative hyperalgesia and a size of more than 20 cm increases the patient’s risk of developing hyperalgesia by more than 7.222 times.展开更多
Objective: In order to identify the correlation between equol excreted through human urine and the symptom of menopause. Methods: The method used is cross sectional study examined to 99 postmenopausal women fulfilling...Objective: In order to identify the correlation between equol excreted through human urine and the symptom of menopause. Methods: The method used is cross sectional study examined to 99 postmenopausal women fulfilling the inclusion criteria from February 2014 to July 2014. This research was taken in the Endocrinology Clinic, Department of Obstetrics and Gynecology, Hasan Sadikin Hospital and Unpad’s Pharmacokinetic Laboratory. All objects were interviewed using menopause rating scale (MRS) questionnaire. Their urine samples were analyzed using high performance liquid chromatography (HPLC). Then the results of questionnaire and HPLC test were evaluated. Results: The result is 97 objects (98%) detected having menopausal symptoms, produced equol. There is significant correlation between the level of equol in post-menopausal women that showed correlation (-0.71) which mean the higher the equol level, the lower the MRS score (p < 0.001) that mean the symptom is milder. Conclusion: Equol level in menopause women urine is a good predictor to identify the level of menopause symptoms.展开更多
<strong>Introduction:</strong><span><span> Human papillomavirus (HPV) infection remains the most common cause of cervical intraepithelial neoplasia. The objective of this study is to evaluate t...<strong>Introduction:</strong><span><span> Human papillomavirus (HPV) infection remains the most common cause of cervical intraepithelial neoplasia. The objective of this study is to evaluate the sensitivity and predictive value of the HPV test associated with the cervico-uterine smear in the screening of cervical intraepithelial neoplasia in our environment. </span><b><span>Methodology:</span></b><span> This is a descriptive cross-sectional study of 625 women who consulted in the department of gynecology for cervical cancer screening, of whom 300 received an HPV test;during the period from January the 1st to December 31</span></span><span>st</span><span>, 2018 at Panzi general reference hospital</span><span> </span><span>(South</span><span>-</span><span><span>Kivu, DRC). Data analysis was done using Epi Info version 7 software. </span><b><span>Results:</span></b><span> For all respondents (n</span></span><span> </span><span>=</span><span> </span><span><span>625), the cervico-uterine smear was normal in 82.88%, inflammatory in 2.4% of cases and with cellular atypia in 14.72%. The HPV test was positive in 87 respondents against 213 negatives cases, </span><i><span>i.e</span></i><span>. a prevalence of HPV of 29% [95% CI: 23.9% - 34.5%]. Among women with precancerous lesions, 27.6% had HPV infection;among those with normal smears, 29.3% of them had HPV infection;however, this difference was not statistically significant. Patients with dysplastic lesions, 31.3% had genotypes with very high carcinogenic potential;and for those with a normal Pap smear, 45.1% had genotypes with very high carcinogenic potential;however, this difference was also not statistically significant. </span><b><span>Conclusion:</span></b><span> The human papillomavirus test remains a very important indication cation in the detection of cervical intraepithelial neoplasia, its sensitivity remaining clearly superior to that of cytology, especially for high grade lesions.</span></span>展开更多
Background: Continuous spinal anesthesia (CSA) is an underused technique in modern anesthesia practice. Compared with other techniques of neuraxial anesthesia, CSA allows incremental dosing of an intrathecal local ane...Background: Continuous spinal anesthesia (CSA) is an underused technique in modern anesthesia practice. Compared with other techniques of neuraxial anesthesia, CSA allows incremental dosing of an intrathecal local anesthetic for an indefinite duration, whereas traditional single-shot spinal anesthesia (SSA) usually involves larger doses, a finite, unpredictable duration, and greater potential for detrimental hemodynamic effects including hypotension, and epidural anesthesia via a catheter may produce lesser motor block and suboptimal anesthesia in sacral nerve root distributions. It is indicated in elderly patients undergoing lower limbs and sub umbilical surgery. Aim: This work aims to highlight the advantages of CSA on hemodynamic stability and as an alternative to heavy anesthetic procedures in already fragile patients. Case presentation: Our cases were two elderly patients, both of them with past stories of cardiac diseases. Both of them were undergoing amputation indicated for wet gangrene on lower limbs. They had unstable hemodynamics states due to inflammatory state. They were all rated ASA 3. CSA was performed with low doses of local anesthetics and maintenance by reinjections of mixture with the same doses. The interventions took place without major incidents and all patients survived. Conclusion: CSA is an underused technique in modern anesthesia. However, there is renewed interest due to the quality of the blocs and the hemodynamics stability. We report a case series of 2 elderly patients with past stories of cardiac diseases undergoing amputation for dry gangrene that had been operated under CSA.展开更多
文摘Background: Artificial intelligence (AI) has the potential to transform medical diagnostics by enhancing the accuracy and efficiency of diagnostic processes. Its application in clinical practice can greatly support medical professionals by offering improved tools for faster and more precise diagnoses. Understanding AI’s capabilities is essential for its successful integration into medical diagnostics. In this context, evaluating the performance of different AI models in the diagnostic process becomes particularly important. The objective of this study is to qualitatively evaluate the diagnostic performance of three AI models—ChatGPT-4o, CodyMD, and Dr. Gupta—based on patient-reported symptoms. Objectives: The aim of the study is to compare the three AI models in terms of diagnostic accuracy, the level of detail in the provided information, the interaction between the models and patients, and the number of differential diagnoses offered. Results: ChatGPT-4o achieved the highest accuracy, correctly diagnosing 90% of the cases. The model provides basic information and focuses on a single most likely diagnosis. CodyMD and Dr. Gupta achieved 50% accuracy, with CodyMD using an interactive approach and offering differential diagnoses with probability percentages for each. Dr. Gupta provided educational medical information and differential diagnoses without probability estimates. Conclusions: The AI models assessed can assist medical professionals in the diagnostic process, but they require further refinement and optimization. ChatGPT-4o stands out for its high accuracy, though increased patient interaction is needed. CodyMD excels in offering an interactive approach and more detailed responses, but requires improved accuracy. Dr. Gupta provided differential diagnoses, but the information provided is suitable for educational purposes. While these models show potential for clinical use, further research is needed to optimize and validate them in real-world settings.
基金supported by the Norwegian Research Council grant no.241011the Norwegian Dental Depot Fund for Dental Research
文摘Streptococcus mitis （S. mitis） is a pioneer commensal bacterial species colonizing many of the surfaces of the oral cavity in healthy individuals. Yet, not much information is available regarding its interaction with the host. We used examination of its transcriptional regulation in oral keratinocytes to elucidate some of its potential roles in the oral cavity. Transcription factor analysis of oral keratinocytes predicted S. mitis.mediated activation of aryl hydrocarbon receptor （AhR）, Activation and functionality of AhR was confirmed through nuclear translocation determined by immunofluorescence microscopy and real-time polymerase chain reaction with reverse transcription analysis of CYPIA1, the hallmark gene for AhR activation. Addition of Streptococcus mutans or Streptococcus gordonfi did not induce CYPIA1 transcription in the keratinocyte cultures. Introduction of an AhR-specific inhibitor revealed that S. mitis-mediated transcription of CXCL2 and CXCL8 was regulated by AhR. Elevated levels of pmstaglandin E2 （enzyme-linked immunosorbent assay） in supernatants from S. mitis-treated oral epithelial cells were also attenuated by inhibition of AhR activity. The observed AhR-regulated activities point to a contribution of S. mitis in the regulation of inflammatory responses and thereby to wound healing in the oral cavity. The concept that the oral commensal microbiota can induce AhR activation is important, also in view of the role that AhR has in modulation of T-cell differentiation and as an anti-inflammatory factor in macrophaees.
文摘Coronary cameral fistula (CCF) is a very rare coronary anomaly in which a communication exists between one of the coronaries and a cardiac chamber. Most of the times it is an incidental finding detected at the time of a coronary angiography. However, sometimes it can have serious presentation like unstable angina, coronary steal or ventricular arrhythmia. We present a rare case of coronary cameral fistula arising from left circumflex artery (LCx) draining in to left ventricular (LV) apex and presenting as unstable angina.
文摘The aim of this study was to develop a simple and derivatization free method for the Quantification of S-Epichlorohydrin in R-Epichlorohydrin by using a gas chromatography coupled with flame ionization detector (FID). Enantiopure epichlorohydrin was a valuable epoxide key starting material for preparing optically active Rivaroxaban. The enantiomeric separations of S-Epichlorohydrin and R-Epichlorohydrin were achieved on Gamaa-Dex-225 (30 meters × 0.25 mm I.D, 0.25 μm) column with a total run time of 30 min. Nitrogen was used as a carrier gas with constant pressure 25.0 psi. The critical experimental parameters such as, column selection, flow rate, injection volume and diluent were studied and optimized. Excellent correlation coeffient between peak responses and concentrations was >0.9998. The recoveries of S-Epichlorohydrin spiked in R-Epichlorohydrin were in the range from 98.2% to 102.8%. Limit of quantitation for S-Epichlorohydrin was sufficiently lower than limits specified by ICH. The method has validated as per International Conference on Harmonization (ICH) guidelines. A precise, accurate, linear and robust Gas Chromatography method was developed for the quantification of S-Epichlorohydrin in R-Epichlorohydrin for Rivaroxaban.
文摘Objective: To describe and analyze the epidemiological aspects as well as the observance of post-exposure prophylaxis (PEP) of people bitten by a dog and received at the Buanionzi State Health Center from 2014 to 2017. Methods: Descriptive cross-sectional study which took place in two stages. The first interview was an interrogation carried out at the health Center until surgical trimming (100% of cases) followed by PEP (70.3% of cases) according to the Essen protocol. The second time was a 24 h telephone interview after a missed appointment for a dose of PEP. Results: The prevalence was 5.6 bites/10.000 people. The average age was 26.4 ± 18.3 years. Age ≤ 26 years was more concerned with 59.3% of cases (p = 0.006) in which children Conclusion: The rabies risk is potential in Boma. Efforts in terms of public health strategies must be made to reduce it.
文摘Breast milk is important for infant health. Some of its benefits are due to the presence of a specific population of bacteria in the microflora. However, the microbiome of breast milk is influenced by many parameters such as maternal diet, breastfeeding and geographic location. Culture and non-culture methods have been used in studies of this bacterial population worldwide. But in the DR Congo, there was no study reporting the use of culture-independent techniques to characterize the bacterial diversity of human milk. The aim of this study was to identify the bacterial 16S rRNA gene from two genera Lactobacillus and Bifidobacterium. The 16S rRNA gene was also identified from four species: Lactobacillus reuteri, Lactobacillus rhamnosus, Bifidobacterium longum and Bifidobacterium lactis. This analytical cross-sectional study was conducted in Kinshasa. Breast milk from some healthy women was collected from February 2 to 28, 2018. A culture-independent protocol using the classical polymerase chain reaction (PCR) was used to identify the bacterial 16S rRNA gene. The 68 samples of breast milk were collected in a sterile condition. The bacteria-specific ribosomal gene 16S rRNA was detected in 91.18% of Lactobacillus and 32.35% of Bifidobacterium at genus level. At of species level, only Lactobacillus reuteri 16S rRNA gene was identified in 89.71%. The 16S rRNA gene from the other species could not be amplified. There was also an association between educational level and the presence of Bifidobacterium and Lactobacillus 16S rRNA genes in the breast milk (p = 0.008*, p Conclusion: This study demonstrates the presence of the bacterial 16S rRNA gene from Lactobacillus and Bifidobacterium in breast milk at the genus and Lactobacillus reuteri at species level. A further study on the diet, use of antibiotics during pregnancy and lactation practice will provide a better understanding of the microflora of breast milk.
文摘The Makiso municipality is located in an urban area influenced by a very high rate of land occupation by houses. This land use has an impact on the quality of the groundwater exploited by wells and springs. This groundwater helps to make up for the deficit caused by the lack of a water distribution network. It is also threatened by pollution from human activities. In order to protect the groundwater in Makiso municipality from pollution, the study of the intrinsic vulnerability assessment in the aquifers was carried out by applying the DRASTIC method and the Geographic Information System (GIS). The results obtained using this method were grouped into two degrees of vulnerability (medium and high), with variations in DRASTIC indices of [141 - 145] for the medium degree and [146 - 175] for the high degree. The high vulnerability class is the most dominant, with a percentage of 96.5% of the study area. The medium vulnerability class, which represents 3.5% of the area of the Makiso municipality, is mainly located in the western (medical plateau district), central (Lualaba district) and southern (commercial district) sectors in the form of isolated pockets. A comparison of the nitrate distribution map with the final vulnerability map shows that the areas defined as highly vulnerable by the DRASTIC method and the areas with high nitrate concentrations (above 0.11 mg/l) are in agreement. On the other hand, there are other areas with low nitrate concentrations (below 0.05 mg/l) which correspond to the high vulnerability indices.
文摘This work presents a study of the Paleogene sandstones of the Manika plateau in Kolwezi, DR Congo. These sandstones belong to the “Grès polymorphes” group, which together with the overlying “Sables ocre” makes up the Kalahari Supergroup. Sedimentological and geochemical analyses have enabled us to characterize these sandstones and determine their origin, the conditions of their formation and the tectonic context in which they were developed. The results show that the sandstones are quartz arenites with a high level of mineralogical, textural and chemical maturity. They are recycled sandstones, formed in an intracratonic sedimentary basin, in the context of a passive continental margin, after a long fluvial transport of sediments. These sandstones initially come from intense alteration of magmatic rocks with felsic composition, mainly tonalite-trondhjemite-granodiorite (TTG) complexes, in hot, humid palaeoclimatic conditions and oxidizing environments.
文摘Some diseases require medical mitigation following the diagnosis, and sometimes the situation means that the patient has to undertake strong medication. However, this medicine is designed pharmacodynamically to interact with other organs before they reach the intended organ. Some mitigation imposes challenges on the involved organ. While the main organ will be healed, some drugs’ footprints will be left out to other organs. These are called iatrogenic injuries. In the case of anastomosis, it requires the alteration of surgical methods or the origin of iatrogenic injury in the arm;thus, the knowledge of anastomosis is very important to the field of medical practice. In addition, carpal tunnel release becomes vital in curing carpal tunnel syndrome. The paper focuses on a case of a 42-year-old woman found to have a complication to her middle finger. This case becomes important for studying Berrettini anastomosis iatrogenic injury, which relates to carpal tunnel syndrome. The Berrettini branch is a complication that facilitates communication between the superficial ulnar and median nerve. The analysis also provides the electro-diagnostic evidence of Berrettini anastomosis on how it can give a position three-finger and thus contribute to a force explanation of the median neuropraxia. Lastly, the paper provides information on the implication of the Berrettini branch for surgical use. The implication of pictures in the digital era can be used to analyze the varied connection and length between the median nerve and ulnar section. It’s easy to locate the position of high risk of iatrogenic injury in the palm due to the consistent location of Berrettini communication branches. The precaution is that operations have to be conducted moderately for a clear vision as the carefully mitigated practice ensures protection from the destruction and injury of the surrounding structures.
文摘<span style="font-family:Verdana;">The “Axillary web syndrome” (AWS) is an early complication following breast cancer surgery with axillary lymph nodes dissection. <strong>Case Report:</strong> The patient is a 69-year-old woman, retired ex-employee, with outcome surgery right axillary lymphadenectomy with shoulder pain and functional limitation with diagnosis AWS it where it was recommended the physiotherapy. The patient had improvement in terms of shoulder function and pain and quality of life. <strong>Conclusions:</strong> The description of the clinical case afflicted with AWS and the treatment protocol applied, highlighted the good performance of the results, notably as concerns patient’s quality of life. This result could represent a starting point for creating clinical trials aimed at building appropriate rehabilitation route in territorial rehabilitation services.</span>
文摘Environmental change is characterized as an alteration in the environment caused primarily by human activities and ecological processes that are natural. Given the fact that the southern part of the province of Haut-Katanga in the Democratic Republic of the Congo (DRC) is part of the African Copperbelt and has been a region of intense mining for decades, humans have affected the physical environment in various ways: such as overpopulation, suburbanization, wastage, deforestation. It is therefore important to track and control the changes in the area’s mining activities. This study aimed to analyze these changes using remote sensing techniques. Landsat satellite images from 2002 and 2022 were processed and classified to quantify changes in built-up area, agricultural land, and vegetation cover over the 20-year period. The classification results revealed sizable differences between the two time points, indicating considerable expansion of built-up land and declines in agricultural land and vegetation cover from 2002 to 2022 in Likasi. These findings provide evidence that urban growth has transformed the landscape in Likasi, likely at the expense of farmland and ecosystems. Further analysis of the remote sensing data could quantify the changes and model future trends to support sustainable land use planning. The land cover and land use analysis were performed with the assistance of the ERDAS 16.6.13 software by mapping LANDSAT data from two different years 2002 and 2022.
文摘Ordinary Portland Cement (OPC) is by mass the largest manufactured product on Earth, responsible for approximately 6% - 8% of global anthropogenic carbon dioxide emissions (CO<sub>2</sub>) and 35% of industrial CO<sub>2</sub> emissions. On average 0.8 to 0.9 ton of CO<sub>2</sub> is emitted to produce one ton of OPC. In this paper, partial substitution of clinker (30% - 35%) by the calcined clay-limestone mixture was investigated in order to produce an eco-cement (LC3). Analyzes by XRF, XRD and ATG/ATD have characterized different components, determined the calcination temperature and selected the right clay which can act as effective Supplementary Cementitious Material (SCM). Mechanical tests on mortar carried out over a period of 90 days. The WBCSD/WRI “Greenhouse Gas Protocol” methodology then allowed the calculation of CO<sub>2</sub> emissions into the atmosphere. Three types of clay are available in the Songololo Region. The kaolinite is the principal clay mineral and its content varies from 27% to 34%. The sum of kaolinite and amorphous phase which enable clay to react with cementitious material ranges from 57% to 60%. The SiO<sub>2</sub> content ranges from 33% to 76%, the Alumina content from 12% to 20% so that the ratio Al<sub>2</sub>O<sub>3</sub>/SiO<sub>2</sub> is on the higher side (0.17 - 0.53). The calcination window is between 750°C and 850°C and the best clay which can act as SCM identified. The clinker’s substitution reduced CO<sub>2</sub> emissions from 0.824 ton of CO<sub>2</sub> for one ton of OPC to 0.640 ton of CO<sub>2</sub> for one ton of LC3, means 22% less emissions. The compressive strengths developed by LC3 vary from 8.91 to 57.6 MPa (Day 1 to Day 90), exceed those of references 32.5 cement and are close to 42.5 cement. In view of the results, LC3 cement can be considered for industrial trials.
文摘Hydrological modeling plays a crucial role in efficiently managing water resources and understanding the hydrologic behavior of watersheds. This study aims to simulate daily streamflow in the Godavari River Basin in Maharashtra using the Soil and Water Assessment Tool (SWAT). SWAT is a process-based hydrological model used to predict water balance components, sediment levels, and nutrient contamination. In this research, we used integrated remote sensing and GIS data, including Digital Elevation Models (DEM), land use and land cover (LULC) maps, soil maps, and observed precipitation and temperature data, as input for developing the SWAT model to assess surface runoff in this large river basin. The Godavari River Basin under study was divided into 25 sub-basins, comprising 151 hydrological response units categorized by unique land cover, soil, and slope characteristics using the SWAT model. The model was calibrated and validated against observed runoff data for two time periods: 2003-2006 and 2007-2010 respectively. Model performance was assessed using the Nash-Sutcliffe efficiency (NSE) and the coefficient of determination (R2). The results show the effectiveness of the SWAT2012 model, with R2 value of 0.84 during calibration and 0.86 during validation. NSE values also ranged from 0.84 during calibration to 0.85 during validation. These findings enhance our understanding of surface runoff dynamics in the Godavari River Basin under study and highlight the suit-ability of the SWAT model for this region.
文摘Zatua Hills are located at Haut Uélé Province of Democratic Republic of Congo (DRC), between northern Bafwasende and southern Paulis (Isiro) Squarred Degrees. Belonging to greenstone belt of Ngayu, that area is identified by the high elevated zone which is remained the witness of stable zone, not affected by the ancienst erosion process. Zatua Hills are in the superior Kibalian formation dated to Neoarchaen, hosted in Upper Congo Granites Massifs of DRC covering a large central zone of NE of DRC, and consisting to dolerite, phyllade, clay rich sediment, poor Banded Iron Formations (BIFs), enriched BIFs, friable hematite, hard hematite, mineralized and unmineralized brechias. Magnetite, martite and hematite are associated to some secondary minerals such as goethite, gibbsite, kaolinite, strengite, variscite and others clay minerals present in BIFs. Petrographic analysis made from the samples collected in situ showed, as well as BIFs and iron ore associated, that magnetite was much abundant oxide mineral which is oxided to martite before to stabilize to hematite during the deposition time. Having about hundred meters of thickness, the rich iron ore of this area content, in the majority less deleterious elements which, are harmful in metallurgic process of iron. These secondary minerals were precipitated at various degrees in the leached cavities of rocks between martite and hematite aggregates to botryoidal texture and, are rich to Al, and are mainly consisting to gibbsite and solid solution series of variscite-strengite (AlPO<sub>4</sub>·2H<sub>2</sub>O and FePO<sub>4</sub>·2H<sub>2</sub>O). Low degree of metamorphism played when magnetite was converted to martite, with the presence of variscite and anatase like witnesses of this event in which, martite was crystalized to hematite.
文摘Rapid and uncontrolled urbanization as well as urban land management are major constraints to land planning in the Democratic Republic of Congo. A household data collection and analysis was carried out in 283 random households in the Nkafu municipality, eastern DR Congo, to assess the local community’s perception of rapid urbanization and its impact on land policy and management of the built landscape. Data of socio-demographics characteristics, rapid urbanization, and environment management data were collected and analyzed using XLStat version 2019. In addition, the study area location map, land use and cover change maps were generated using ArcMap 10.8. Results indicate that landowners are dominant and, build simple houses with unsustainable building materials (i.e. wooden plank) obtained locally. In addition, land management is not appreciated by local communities, due to anarchic construction due to lack of financial resources generating thus an increasing amount of urban waste, which is poorly managed. The study suggests, urban roads renew, building in conformity with urban planning and building regulations, potable water supply and health services availability to improve the study area. Geographic Information Systems (GIS) use, would provide spatial information on land planning in the study area.
文摘Zatua Hills are located in the northeastern part of the DR Congo in Haut Uélé Province, formerly known as Province Orientale. This part of DR Congo is identified by the high elevated zone, which has remained a witness to a stable zone not affected by the ancient erosion process. BIFs are most abundant and are dated to the Neoarchaean and Late Kibalian, hosted in the Upper Congo Granites Massifs of the DR. Congo. Zatua Hills consist of dolerite, phyllade, clay-rich sediment, poor itabirite, enriched BIFs, friable hematite, hard hematite, and mineralized and unmineralized breccias. Field study and geochemistry analysis by XRF, XRD, and ICP-MS are executed in order to know the geochemistry signature and paragenesis of Zatua Hills and the probably process could lead the BIFs to iron ore. The geochemistry analysis by XRF, XRD, and ICP-MS shows that Iron ore content has an iron rate between 57% and 69% with less deleterious elements such as Si, P, and Al. These deleterious elements are secondary and have silicium composition (probably quartz or chert, goethite, and Kaolinite), aluminum (probably gibbsite, variscite, cadwaladérite, goethite, and Kaolinite), phosphorous (probably variscite), and hydrated minerals, which are grown LOI in the samples. Hypogen and supergen processes are played in BIFs for iron ore conversion and, respectively, silica dissolution and leaching. Metamorphism was also impacted and marked by the Ti element (anatase) in samples, contributing to the crystallization of martite to hematite after magnetite oxidation.
文摘Background: It appeared that the conjunction inflammation and nerve damage (caused by surgery) generate the hyperalgesic component. But the probability of predicting hyperalgesia from the size of the surgical incision and/or the resulting inflammatory reaction is not well elucidated. This survey aims to study the influence of the size of the surgical incision and the resulting inflammatory reaction (interleukin 6 levels) in the occurrence of postoperative hyperalgesia in the population of Lubumbashi. Methods: The present study was descriptive cross-sectional. The data collection was prospective over 5 months, from February 1, 2024 to June 30, 2024. This study included any patient over the age of 18 who underwent surgery under general anesthesia. We used indirect signs to define hyperalgesia: higher (ENS > 6) and prolonged pain, postoperative overconsumption of morphine. Results: During our survey, we collected 48 operated patients who had severe postoperative pain, 16 of whom had hyperalgesia, i.e. a prevalence of hyperalgesia of 33.33%. The size of the incision most represented was between ≥20 and i.e. 62.50%. The type of surgery most affected by hyperalgesia was laparotomy. We observed an elevation of IL6 in 87.50% of patients. The largest elevation was 8.91 times the preoperative value and the smallest was 1.04 times. Pre- and postoperative IL6 levels were not associated with hyperalgesia (p = 0.265). Only the size of the surgical incision was associated with hyperalgesia (p = 0.04). Incision size values between [20 - 30] cm were those associated with hyperalgesia (p = 0.027). The model shows that making an incision greater than or equal to 20 cm increases the patient’s risk of developing hyperalgesia by more than 7.222 times and this is statistically significant (p = 0.004). Conclusion: According to this survey, the size of the surgical incision was associated with postoperative hyperalgesia and a size of more than 20 cm increases the patient’s risk of developing hyperalgesia by more than 7.222 times.
文摘Objective: In order to identify the correlation between equol excreted through human urine and the symptom of menopause. Methods: The method used is cross sectional study examined to 99 postmenopausal women fulfilling the inclusion criteria from February 2014 to July 2014. This research was taken in the Endocrinology Clinic, Department of Obstetrics and Gynecology, Hasan Sadikin Hospital and Unpad’s Pharmacokinetic Laboratory. All objects were interviewed using menopause rating scale (MRS) questionnaire. Their urine samples were analyzed using high performance liquid chromatography (HPLC). Then the results of questionnaire and HPLC test were evaluated. Results: The result is 97 objects (98%) detected having menopausal symptoms, produced equol. There is significant correlation between the level of equol in post-menopausal women that showed correlation (-0.71) which mean the higher the equol level, the lower the MRS score (p < 0.001) that mean the symptom is milder. Conclusion: Equol level in menopause women urine is a good predictor to identify the level of menopause symptoms.
文摘<strong>Introduction:</strong><span><span> Human papillomavirus (HPV) infection remains the most common cause of cervical intraepithelial neoplasia. The objective of this study is to evaluate the sensitivity and predictive value of the HPV test associated with the cervico-uterine smear in the screening of cervical intraepithelial neoplasia in our environment. </span><b><span>Methodology:</span></b><span> This is a descriptive cross-sectional study of 625 women who consulted in the department of gynecology for cervical cancer screening, of whom 300 received an HPV test;during the period from January the 1st to December 31</span></span><span>st</span><span>, 2018 at Panzi general reference hospital</span><span> </span><span>(South</span><span>-</span><span><span>Kivu, DRC). Data analysis was done using Epi Info version 7 software. </span><b><span>Results:</span></b><span> For all respondents (n</span></span><span> </span><span>=</span><span> </span><span><span>625), the cervico-uterine smear was normal in 82.88%, inflammatory in 2.4% of cases and with cellular atypia in 14.72%. The HPV test was positive in 87 respondents against 213 negatives cases, </span><i><span>i.e</span></i><span>. a prevalence of HPV of 29% [95% CI: 23.9% - 34.5%]. Among women with precancerous lesions, 27.6% had HPV infection;among those with normal smears, 29.3% of them had HPV infection;however, this difference was not statistically significant. Patients with dysplastic lesions, 31.3% had genotypes with very high carcinogenic potential;and for those with a normal Pap smear, 45.1% had genotypes with very high carcinogenic potential;however, this difference was also not statistically significant. </span><b><span>Conclusion:</span></b><span> The human papillomavirus test remains a very important indication cation in the detection of cervical intraepithelial neoplasia, its sensitivity remaining clearly superior to that of cytology, especially for high grade lesions.</span></span>
文摘Background: Continuous spinal anesthesia (CSA) is an underused technique in modern anesthesia practice. Compared with other techniques of neuraxial anesthesia, CSA allows incremental dosing of an intrathecal local anesthetic for an indefinite duration, whereas traditional single-shot spinal anesthesia (SSA) usually involves larger doses, a finite, unpredictable duration, and greater potential for detrimental hemodynamic effects including hypotension, and epidural anesthesia via a catheter may produce lesser motor block and suboptimal anesthesia in sacral nerve root distributions. It is indicated in elderly patients undergoing lower limbs and sub umbilical surgery. Aim: This work aims to highlight the advantages of CSA on hemodynamic stability and as an alternative to heavy anesthetic procedures in already fragile patients. Case presentation: Our cases were two elderly patients, both of them with past stories of cardiac diseases. Both of them were undergoing amputation indicated for wet gangrene on lower limbs. They had unstable hemodynamics states due to inflammatory state. They were all rated ASA 3. CSA was performed with low doses of local anesthetics and maintenance by reinjections of mixture with the same doses. The interventions took place without major incidents and all patients survived. Conclusion: CSA is an underused technique in modern anesthesia. However, there is renewed interest due to the quality of the blocs and the hemodynamics stability. We report a case series of 2 elderly patients with past stories of cardiac diseases undergoing amputation for dry gangrene that had been operated under CSA.
