scholarly journals Epidemiological, clinical and evolutionary aspects of hypotrophic newborns at term at the Mother and Child University Hospital of N'Djamena

2022 ◽  
Vol 13 (1) ◽  
pp. 180-188
Silé Souam Nguélé ◽  
Adrienne Ngaringuem ◽  
Kounnezouné Patalet ◽  
Kanezouné Gongnet ◽  
Djaury Dadji-a ◽  

Introduction: Hypotrophy is a public health problem in developing countries. Its etiology is multifactorial and it may be associated with high morbidity and mortality. The objective of this study was to describe the epidemiological, clinical and evolutionary profile of hypotrophic newborns at term. Methodology: this was a prospective, descriptive and analytical study conducted in the neonatology department of the MCUH of N'Djamena from 01/06/2018 to 31/05/2019. It involved 109 hypotrophic newborns at term hospitalized. Results: The frequency of hypotrophy was 7.8%, the risk factors were: housewife status (81.7%), low level of education (67%), poor pregnancy follow-up (59.7%), malaria (40.4%), urogenital infections (22%) and anemia (22%) during pregnancy. Hypotrophy was harmonious in 58.7% of cases, the sex ratio was 1.14 and visible congenital malformations were observed in 12.7% of cases. The main reasons for hospitalization were neonatal infections (64.2%), perinatal asphyxia (14.7%) and hypothermia (11.9%). Lethality was 16.5% and associated with multiparity, poor pregnancy follow-up, vaginal delivery, home delivery, pathological Apgar score, notion of resuscitation, existence of malformation, respiratory distress and perinatal asphyxia. Conclusion: Better monitoring of pregnancy, use of family planning by couples, delivery in an institutionalized setting, and reinforcement of the technical platform of the neonatology department will reduce neonatal morbidity and mortality related to hypotrophy.

2008 ◽  
Vol 66 (2a) ◽  
pp. 168-174 ◽  
Magda Lahorgue Nunes ◽  
Maurer Pereira Martins ◽  
Bianca Menke Barea ◽  
Ricardo C. Wainberg ◽  
Jaderson Costa da Costa

OBJECTIVE: To describe the neurological outcome of newborns with seizures. METHOD: Cohort study with newborns prospectively followed. Perinatal characteristics and etiological screening were related to outcome in a regression model. RESULTS: During the study 3659 newborns were admitted and 2.7% were diagnosed as having seizures. Hypoxic ischemic encephalopathy (51%) was the etiology more frequently associated to seizures and also to postneonatal epilepsy (53%). In the follow up 25 died during the acute neonatal illness and 9 during the first years of life, 19 were diagnosed as having post neonatal epilepsy, 35 had developmental delay and 11 an association among this two comorbidities. A significant association between abnormal postnatal EEG and neuroimaging to developmental delay (p=0.014, p=0.026) was observed. The group of newborns that had seizures presented an increased risk of developing epilepsy compared to newborns from the same cohort without seizures (19.3/100 vs. 1.8/100, p<0.001). CONCLUSION: In this study neonatal seizures predominated in term newborns with perinatal asphyxia an elevated perinatal mortality and post neonatal morbidity was observed.The follow up showed an increased risk for developing postnatal epilepsy and developmental delay.

2020 ◽  
pp. 1-3

Tuberculosis is a global public health problem and is among the top ten causes of mortality in the world. We present the unusual case of a 37-year-old woman, referred for fever, progressive headache, nausea, vomiting and change in mental status. Brain imaging studies. showed a left frontal brain abscess with subfalcin herniation. As an urgent procedure, surgical drainage of the brain abscess was performed, and in the culture of pus there was growth of an anaerobic Streptococcus. The histopathological study of the abscess wall showed data on tuberculosis. The patient was pregnant at surgery, for about five weeks and received anti-tuberculous medications with close maternal fetal follow-up. Pregnancy came to term and was resolved by an elective cesarean section, both mother and child had a favorable evolution.

2018 ◽  
Vol 9 ◽  
pp. 215145851775051 ◽  
Franz Müller ◽  
Michael Galler ◽  
Christina Roll ◽  
Bernd Füchtmeier

Introduction: The surgical treatment of proximal femoral fractures predominantly involves geriatric patients and is associated with high morbidity and mortality. However, analyses on postoperative infections or hematoma are rare. Methods: Patients requiring surgical revision due to infection (n = 90) or hematoma (n = 77) in the postoperative phase were identified from an electronic database of 2000 consecutive patients surgically treated for proximal femoral fractures between 2006 and 2014. Demographic and clinical data were retrieved, including information on the pathogens in patients with infection. A follow-up on morbidity and mortality was conducted via telephone for at least 2 years postsurgery. Results: The follow-up rate was 100%, and the mean age was 81.9 years. The incidence rate of infection was 4.1% (90/2000), and women were commonly affected. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly detected pathogens (35.5% and 25.5%, respectively). Mixed infections were observed in 15 patients, and Methicillin-resistant Staphylococcus aureus infections were observed in only 4 patients. A total of 77 (85.6%) infections occurred within 30 days postsurgery. The implant was preserved in 76 (84.4%) patients, and resection arthroplasty was required in 14 patients. Dementia and pertrochanteric fractures were significantly more common in the infection than in the hematoma group. Although infections were associated with high mortality rates for up to 2 years postsurgery, the rates did not significantly differ from those in the hematoma control group. Conclusion: One of every 2 patients who developed an infection following the surgical treatment of a proximal femoral fracture died within 2 years postsurgery. In addition, infections were significantly associated with dementia. Avoiding postoperative infection should be a high priority in the surgical treatment of proximal femoral fractures.

2021 ◽  
Vol 2 (6) ◽  
Fombotioh Ndifor ◽  
Abakar Idriss Lawane ◽  
Nadjioroum Ngam-Asra ◽  
Mouktar Abaya Adoum ◽  
Brahim Boy Otchom ◽  

Acute diarrhea is one of the leading causes of morbidity and mortality in children from 0-5 months old, especially in Africa and many developing countries. Rotavirus and Adenovirus have been recognized as the common pathogens for this public health problem. However, little or no investigation has been carried out on the two viruses in Chad. In view of this fact, we decided to study the prevalence of Rotavirus and Adenovirus in children suffering from acute diarrhea at the University Hospital Center of Mother and Child (UHC-MC). Fresh stool samples were collected from 440 children ages 0-5 years (225 females and 2015 males). They were brought for medical consultation from March 2019- September 2019 at the pediatric department. Specimens were analyzed and Rotavirus and Adenovirus were detected using Rapid Immunochromatographic Test kit (Vikia BioMerieux, France). Out of the 440 children examined, 228 had viral infection with a prevalence of 51.81%. Based on gender infection, females 140 (62.22%) were significantly more infected than males 88(40.93%). Prevalence of mono infection of Rotavirus in children 110 (48.24%) was higher than that of Adenovirus 74(32.45%). More males had Rotavirus infection 60(68.18%) than girls 50 (37.71%). Co-infection was found to be 44 (19.29%). Distribution of viral infection indicated that children between 6-11 months had the highest viral burden 101(77.69%). Among clinical symptoms recorded, dehydration was the highest in children 84(61.76%). Due to the high prevalence of Rotavirus and Adenovirus discovered, we suggest that vaccines for the two viruses should be included in the national immunization program.

2019 ◽  
Vol 12 (5) ◽  
pp. 620-628 ◽  
Jiahua Li ◽  
Christopher O Fagbote ◽  
Min Zhuo ◽  
Chelsea E Hawley ◽  
Julie M Paik

Abstract Chronic kidney disease (CKD) is a critical global public health problem associated with high morbidity and mortality, poorer quality of life and increased health care expenditures. CKD and its associated comorbidities are one of the most complex clinical constellations to manage. Treatments for CKD and its comorbidities lead to polypharmacy, which exponentiates the morbidity and mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have shown remarkable benefits in cardiovascular and renal protection in patients with type 2 diabetes mellitus (T2DM). The pleiotropic effects of SGLT2is beyond glycosuria suggest a promising role in reducing polypharmacy in diabetic CKD, but the potential adverse effects of SGLT2is should also be considered. In this review, we present a typical case of a patient with multiple comorbidities seen in a CKD clinic, highlighting the polypharmacy and complexity in the management of proteinuria, hyperkalemia, volume overload, hyperuricemia, hypoglycemia and obesity. We review the cardiovascular and renal protection effects of SGLT2is in the context of clinical trials and current guidelines. We then discuss the roles of SGLT2is in the management of associated comorbidities and review the adverse effects and controversies of SGLT2is. We conclude with a proposal for deprescribing principles when initiating SGLT2is in patients with diabetic CKD.

2017 ◽  
Vol 41 (S1) ◽  
pp. s901-s901
E. Di Giacomo ◽  
M. Calabria ◽  
F. Colmegna ◽  
B. Pucci ◽  
M. Clerici

Pregnancy denial was observed in a patient after her second delivery. Contrary to the first pregnancy, she denied weight gain, body changes and baby movements. She reported using a contraceptive pill throughout the entire pregnancy. After a short home delivery without assistance, she was admitted to obstetrical department and referred for psychiatric evaluation. Mrs. T. accepted psychiatric follow-up appointments and was followed up for 6 months. She was initially assessed using the SCID II Interview, beck anxiety and depression interview, WHOQOL (WHO quality of life), and childhood trauma questionnaire. She denied pregnancy concealment and during the period of assessment and follow-up there was no evidence of intimate partner violence. Her female newborn was healthy without consequences of oestrogen/progesteron absorption (hypoplastic left heart syndrome, gastroschisis, hypospadias or congenital urinary trait anomalies) in one year follow up. The patient was discharged after 6 months of clinical outpatient follow-up. This case stresses and emphasizes the health and risk outcomes for both mother and child linked to an underestimated but serious phenomenon such as the denial of pregnancy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2018 ◽  
Vol 35 (12) ◽  
pp. 1228-1234 ◽  
Cynthia Gyamfi-Bannerman ◽  
Joseph Biggio ◽  
Suneet Chauhan ◽  
Brenna Hughes ◽  
Judette Louis ◽  

AbstractThe objective of this commentary is to describe the background, rationale, and methods of the PROLONG (Progestin's Role in Optimizing Neonatal Gestation) trial, which is a multicenter, multinational, placebo-controlled, randomized clinical trial (RCT) designed to assess the safety and efficacy of Makena (hydroxyprogesterone caproate injection, 250 mg/mL) in reducing the risk of preterm birth (PTB) and neonatal morbidity/mortality in women pregnant with a singleton gestation who had a previous singleton spontaneous PTB. The total sample size of the RCT will include 1,707 women. The trial has two coprimary outcomes: PTB less than 35 weeks and a composite neonatal morbidity and mortality index. This study sample size will provide 90% power to assess for a 35% reduction in neonatal morbidity and mortality. Secondary outcomes will include 2-year follow-up of infants. The trial is ongoing and targeted to complete recruitment in 2018.

2021 ◽  
pp. 47-49
Ranjana Sharma ◽  
Manju Agarwal

Background- The occurrence of meconium-stained amniotic uid (MSAF) during labor has long been considered the predictor of adverse fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia, which leads to perinatal and neonatal morbidity and mortality Methods- A Prospective observational study was carried out in Smt. Hira Kunwar Ba Mahila Hospital, Jhalawar attached to Jhalawar Medical College,over one year from January 2020 to January 2021. Total 278 cases taken at random basis having following inclusion criteria Result- MSL is responsible for neonatal morbidity in 15.1% of cases. Rate of neonatal morbidity was higher in thick meconium group (24.9%) as compared to thin meconium group (6.2%) and this difference was statistically signicant. In our study birth asphyxia (5.8%) was the most common complication followed by MAS (4%), Pneumonitis (3.6%) and Sepsis (1.8%). Conclusion- Passage of meconium still remains as an enigma to the obstetrician and equally worries the paediatrician. As shown in the study, thick meconium is associated with increased operative intervention, low apgar score, increased rate of NICU admission and increased risk of neonatal morbidity and mortality as compared to thin meconium.

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Kidest Getu Melese ◽  
Mignote Hailu Gebrie ◽  
Martha Berta Badi ◽  
Wubalem Fekadu Mersha

Introduction. Unintended pregnancy is defined as a pregnancy which is a sum of mistimed pregnancy (pregnancy wanted at a later time) and unwanted pregnancy (pregnancy which is not wanted at all). Unintended pregnancy is a global public health problem and its sequels are major causes for maternal and neonatal morbidity and mortality with its effect to maternal metal illness as well.Objective. To determine the prevalence and associated factors of unintended pregnancy in Debre Birhan town, northeast of Ethiopia, in 2014.Method. Community based cross-sectional study and questionnaire developed from Ethiopian demographic health survey 2011. Participants were 690 currently pregnant mothers. Association of unintended pregnancy with factors was measured with bivariate and multivariate logistic regressions.Result. In this study unintended pregnancy is found to be 23.5%. Being formerly married and never married, distance to the nearest health facility>80 minutes, gravidity>5, 1-2 parity, and partner disagreement on desired number of children are the variables significantly associated with unintended pregnancy.Conclusion. Significant proportion of unintended pregnancy is found in the study area. To minimize unintended pregnancy concerned bodies should work on the identified factors, so we can minimize maternal and neonatal morbidity and mortality and keep the health of the family specifically and country in general.

2005 ◽  
Vol 35 (3) ◽  
pp. 183-184 ◽  
V Ertekin ◽  
H Alp ◽  
S Altinkaynak ◽  
M A Selimogğlu

Thirty-eight cases of tuberculous meningitis in children were studied. Mortality was 28.9%; most of these presented with stage III disease. Tuberculous meningitis (TBM) still ranks as one of the most important communicable diseases in terms of morbidity and mortality. It is universally fatal if not treated and has high morbidity and mortality, if not recognized early. According to WHO's data, 1.3 million new TB cases under 15 year olds were reported. In Turkey, the TB prevalence is 0.4 %. According to data from the Turkish Ministry of Health, the number of admissions to hospitals dropped from 108 per 100,000 in 1971 to 51 per 10,000 in 1988. Early diagnosis and treatment of TBM are essential in order to prevent late sequelas and death. The diagnosis of TBM may be delayed because many patients initially have vague, seemingly minor, signs and symptoms. In this study, the clinical and laboratory findings of 38 patients with the diagnosis of TBM in our hospital were reviewed, retrospectively, during the past five years. Our purpose was to stress the importance of TBM as a public health problem in Turkey, particularly in the Eastern of Turkey.

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