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factors associated with fracture-settlement were smoking and the localization of MSCC. Back pain was the most common clinical sign and fracture-settlement was the first type of injury on medical magnetic resonance imaging. Therefore, we recommend that emphasis should be placed on increasing awareness of the population on the importance of early diagnosis.The implementation of electronic data collection during supportive supervision visits (ISS) using the Open Data Kits (ODK) Collection in Niger has provided a factual basis for monitoring the performance of the Polio eradication program (PEP) and the immunization program. With the notification of the first case of COVID-19 on 19 March 2020, there was a rapid need for quality knowledge to monitor the pandemic. For the first time in Niger, we initiated a six-month (May to October 2020) joint ISS-COVID-19 surveillance program to improve and monitor healthcare workers' performance to efficiently investigate COVID-19 cases in eight provinces. Overall, 1,378 ISS visits were performed through 390 health facilities, during which 4,638 health workers were trained and 527,151 medical records were reviewed, of which 28 suspected cases of COVID-19 were found. Field visits for contact tracing in their communities were accomplished and closed monitoring ensured until full recovery. Building on the tradition of PEP, a problem-solving process, feedback and on-the-job training on COVID-19 surveillance is set to enhance notification in the coming weeks and months. This is facilitated by accurate use of ODK Collect for real-time data surveillance successfully implemented. Other topics in the briefing included fundamentals of infection prevention and control for COVID-19 for both health professionals and community leaders. From this experience, the ISS has emerged as a key component of COVID-19 surveillance, especially in regions with a fragile health system. Our observation is a step forward for pragmatic interventional studies.Breast fibromatosis is a benign breast tumor of mesenchymal origin, accounting for 0.2% of breast tumors. This study reports two cases of breast fibromatosis highlighting its diagnostic, morphological, therapeutic and evolutionary features. In both cases, this tumor clinically and radiologically mimicked a cancer. Diagnostic confirmation was based on histological examination. Breast fibromatosis was characterized by local progression and a tendency to recurrence, hence the role of surgical excision with free surgical margins in our patients. The role of locoregional treatments (radiotherapy and cryotherapy) and medical treatments, in particular anti-estrogen therapy, is not clearly defined. In conclusion, breast fibromatosis must be known as it mimicks breast cancer and is characterized by a very high recurrence rate, without ever developing metastases.

congenital diaphragmatic hernia has been rarely reported in Africa. It can manifests early or late. Prognosis mainly depends on associated malformations. The purpose of this study is to report our experience in the Albert Royer National Children's Hospital, Dakar, Senegal.

we conducted a retrospective study of patients treated for congenital diaphragmatic hernia between January 2010 and December 2019.

twelve patients were enrolled, with an average age of 8.9 months. Bochdalek hernias were detected in 10 patients. The most common symptoms were respiratory symptoms (83.3%), followed by digestive symptoms (41.6%). Thoraco-abdominal X-ray was used to make a diagnosis in all patients. Three patients underwent preoperative stabilization. All patients underwent laparotomy. Hernia sac was found in 10 patients, and 50% of patients had a defect measuring between 5 and 10 cm. The postoperative course was simple in 10 patients; a polymalformed patient died.

congenital diaphragmatic hernia is a reality in our environment; it most often manifests beyond the neonatal period. Prognosis is generally good in our context.

congenital diaphragmatic hernia is a reality in our environment; it most often manifests beyond the neonatal period. Prognosis is generally good in our context.Epidural hematoma (EDH) is defined as a traumatic accretion of blood separating the dural membrane and the internal table of the skull that caused from contact bending or skull fracture. The cases of contrecoup EDH are as not common, and there are just 10 recorded cases on this. As a result of its uncommonness, we disclose one subject of a 33-year-old man having countrecoup EDH who suffered from a head trauma caused by falling from 4 meters high. The main symptoms were decreasing consciousness and vomiting. Clinical findings showed a Glasgow Coma Scale score of 9, laceration in the left parietal region with stable hemodynamic. PDD00017273 supplier Head Computed tomography showed a large EDH in the right frontal and temporal region with coronal suture diastasis. The patient immediately underwent surgery, and craniotomy with evacuation of extradural hematoma were performed. This case presents that a force, which creates an angle, can propagates and causes opposite coronal suture diastasis and makes contrecoup EDH.

male partner involvement in antenatal care (ANC) contributes to improved maternal health outcomes, but has been wanting in sub-Saharan Africa. We investigated the prevalence and factors associated with male involvement in ANC.

this was a cross-sectional survey conducted in November and December 2019 in Kitui East sub-county, Kenya. We recruited men above 18 years whose spouses had given birth 12-months prior to the study. Data were collected at the household level using an interviewer-administered questionnaire. Male involvement was defined as provision of physical, psycho-social, decision-making, and financial support, which was measured through twelve questions. Factor scores of the twelve questions were generated by fitting a Rasch model. Participants who scored at least 75% were involved. Bivariate and multivariate logistic regression models were fitted to identify the independent predictors of male involvement.

a total of 300 participants were interviewed. The mean age was 36.7 years (SD=±7.6), 52.tive in order to improve male involvement.

more than half of the participants reported involvement in ANC, which was significantly associated with previous ANC experience and having less than four children. Empowering men with knowledge on ANC and joint decision-making with their spouses is imperative in order to improve male involvement.Adolescents (10 to 19 years) living with HIV (ALHIV) experience disproportionately poor adherence to antiretroviral treatment (ART) compared to other age groups. Several barriers, including psychosocial challenges, contribute to this observation. Psychosocial support (PSS) interventions show promising results as a strategy to deal with the biological and psychosocial challenges faced by ALHIV. However, there is dearth of information on how psychosocial support interventions designed to improve treatment adherence and retention in care among ALHIV are effective. In this commentary, we used the biopsychosocial model to formulate hypotheses on how the components of a PSS intervention could improve adherence and retention in ART care. Psychological wellbeing, coping strategies, social support, self-efficacy, and disclosure are key components in the intervention designed to improve ART adherence and retention in care. The management of ALHIV for improved ART adherence and retention requires recognising and addressing the complex biological, psychological and social issues peculiar to them.While it is clear that the ovarian hormones estradiol and progesterone have important influences on physiological thermoregulation in women, the influences of these hormones on responses to cold exposure are not well understood. Both heat conservation and heat production must increase to offset heat losses that decrease body temperature in cold ambient conditions. Cutaneous vasoconstriction conserves heat, whereas shivering and non-shivering thermogenesis produce heat - all as part of reflex physiological responses to cold exposure. Our goal in this brief review is to highlight existing knowledge and recent advances pertaining to sex and sex hormone influences on thermoeffector responses to cold stress. Estrogens have multiple influences that contribute to heat dissipation and a lower body temperature, while the influence of progesterone appears to primarily increase body temperature. Fluctuations in estrogen and progesterone across the menstrual cycle can alter the level at which body temperature is regulated. Recent evidence suggests that female reproductive hormones can modulate the cutaneous vasoconstrictor response, and may influence metabolic mechanisms such as substrate utilization during shivering and non-shivering thermogenesis. Overall, it appears that quantitative differences in cold thermoregulation between sexes are minimal when anthropometric measures are minimized, such that women do not have a strong "advantage" or "disadvantage" in terms of overall ability to tolerate cold. Thermoregulatory physiology in women during cold exposure remains relatively understudied and many mechanisms require further elucidation.The present comprehensive review (i) summarizes the current knowledge on the impacts of occupational heat stress on outdoor workers, (ii) provides a historical background on this issue, (iii) presents a meta-analysis of published data, (iv) explores inter-individual and intra-individual factors, (v) discusses the available heat mitigation strategies, (vi) estimates physical work capacity, labour productivity, and metabolic rate for the year 2030, and (vii) provides an overview of existing policy and legal frameworks on occupational heat exposure. Meta-analytic findings from 38 field studies that involved monitoring 2,409 outdoor workers across 41 jobs in 21 countries suggest that occupational heat stress increases the core (r = 0.44) and skin (r = 0.44) temperatures, as well as the heart rate (r = 0.38) and urine specific gravity (r = 0.13) of outdoor workers (all p less then 0.05). Moreover, it diminishes the capacity of outdoor workers for manual labour (r = -0.82; p less then 0.001) and is responsible for more than two thirds of the reduction in their metabolic rate. Importantly, our analysis shows that physical work capacity is projected to be highly affected by the ongoing anthropogenic global warming. Nevertheless, the metabolic rate and, therefore, labour productivity are projected to remain at levels higher than the workers' physical work capacity, indicating that people will continue to work more intensely than they should to meet their financial obligations for food and shelter. In this respect, complementary measures targeting self-pacing, hydration, work-rest regimes, ventilated garments, and mechanization can be adopted to protect outdoor workers.There has been an explosion recently in our understanding of the neuronal populations in the preoptic area involved in thermoregulation of mice. Recent studies have identified several genetically specified populations of neurons predominantly in the median preoptic nucleus (MnPO) but spreading caudolaterally into the preoptic area that regulate body temperature. . These include warm-responsive neurons that express the peptides PACAP, BDNF, or QRFP; and receptors for temperature, leptin, estrogen, or prostaglandin E2 (PGE2). These neurons are predominantly glutamatergic and driving them opto- or chemogenetically can cause profound hypothermia, and in some cases, periods of torpor or a hibernation-like state. Conversely, fever response is likely to depend upon inhibiting the activity of these neurons through the PGE2 receptor EP3. Another cell group, the Brs3-expressing MnPO neurons, are apparently cold-responsive and cause increases in body temperature. MnPO-QRFP neurons cause hypothermia via activation of their terminals in the region of the dorsomedial nucleus of the hypothalamus (DMH).