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05), time taken to the facility (X2 (3) = 34.72; p less then 0.05), and waiting time (X2 (3) = 14.17; p less then 0.05) were found to significantly influence utilization of FANC services. Therefore, women should be empowered through education and economic activities to remain financially independent. The government should also improve access to health care, especially in rural areas, by building new health facilities to improve the utilization of FANC services. Besides, more health care providers should be employed to reduce the waiting time at the facility.

the spread of enterobacteria producing extended-broad-spectrum beta-lactamases (ESBL) is a global public health-problem. In a study carried in 2003-2005 at the Pasteur Institute in Bangui, 450 enterobacteria were identified in clinical isolates, of which 17 were ESBL (prevalence 3.78%). The aim of this study was to update this data.

from May 2018 to April 2019, a total of 941 enterobacteria were isolated and identified under identical conditions of recruitment and with the same techniques used in the previous study phenotypic identification using Api 20E strips (bioMérieux SA, Marcy-l'Etoile, France) and antimicrobial drug susceptibility using the disk diffusion method (Bio-Rad antibiotic discs, Marnes la Coquette, France). Resistance genes were identified by polymerase chain reaction (PCR) and sequencing.

from May 2018 to April 2019, a total of 941 enterobacteria were isolated of which 478 were ESBL, thus amounting to a prevalence of 50.80%. The genetic profiles of the bla CTX-M resistance genes exhibited the emergence of the CTX-M28 variant (CTX-M1 group) and variants of the M2 and M9 groups. There was also a notable increase, from 35 to 64%, in the ESBL with a bla SHV gene.

this study documents a 13 fold increase in the prevalence of ESBL derived from clinical isolates of the bacteriology laboratory of the Institute Pasteur in Bangui, by comparing its data with that of the publication by Frank et al. 2006. Together with this increase a significant diversification of the circulating CTX-M resistance genes was noticed.

this study documents a 13 fold increase in the prevalence of ESBL derived from clinical isolates of the bacteriology laboratory of the Institute Pasteur in Bangui, by comparing its data with that of the publication by Frank et al. 2006. Together with this increase a significant diversification of the circulating CTX-M resistance genes was noticed.Split-hand foot malformation (SHFM) is a clinically heterogeneous congenital limb defect affecting predominantly the central rays of hands and/or feet. The clinical expression varies in severity between patients as well between the limbs in the same individual. SHFM might be non-syndromic with limb-confined manifestations or syndromic with extra-limb manifestations. Isolated SHFM is a rare condition with an incidence of about 1 per 18,000 live born infants and accounts for 8-17 % of all limb malformations. To date, many chromosomal loci and genes have been described as associated with isolated SHFM, i.e., SHFM1 to 6. SHFM6 is one of the rarest forms of SHFM, and is caused by mutations in WNT10B gene. Less than ten pathogenic variants have been described. We have investigated a large consanguineous Moroccan family with three affected members showing feet malformations with or without split hand malformation phenotypes. Using an exome sequencing approach, we identified a homozygous nonsense variant p.Arg115* of WNT10B gene retaining thereby the diagnosis of SHFM6. This homozygous nonsense mutation identified by exome sequencing in a large family of split hand foot malformation highlights the importance of exome sequencing in genetically heterogeneous entities.

incidental prostate cancer findings reflect the great burden of prostatic cancer across the globe. Our 10 year retrospective analysis aimed to identify the incidence and clinic-pathologic features of prostate cancer incidentally detected in patients undergoing transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH), and to estimate the clinical value of pathologic review of all TURP specimens.

after excluding patients with a known diagnosis of prostate cancer prior to TURP a total of 2,386 men (ages 25-98) were identified by pathology (TURP) specimens. Yearly incidences, Gleason score, grade, pathologic stage were recorded for all incidental prostate cancer patients.

a total of 256 (10.7%) patients were found to have prostate cancer. Mean Age was 68.51±9.22 years. T1a and T1b stage prostatic carcinoma was found in 9.9% and 90.1% of these patients respectively. Forty-nine percent (49%) patients had higher Gleason scores (>7). After subtracting average incidences between 5ention. The diverse ethnic and socioeconomic background of patients propels their propensity towards loss of follow up with already limited tertiary healthcare institutes in Pakistan. This pathologic review of TURP specimens is valuable for Asiatic and non-Asiatic populations.

the spread and diffusion of COVID-19 undoubtedly shows strong spatial connotations and alignment with the physical indices of civilization and globalization. Several spatial risk factors have possible influence on its dispersal trajectory. Understanding their influence is critical for mobilization, sensitization and managing non-pharmaceutical interventions at the appropriate spatial-administrative units.

on 01 April 2020, we constructed a rapid spatial diagnostics and generated vulnerability map for COVID-19 infection spread at state level using 12 core spatial drivers. The risk factors used include established COVID-19 cases (as at 01 April 2020), population, proximity to the airports, inter-state road traffic, intra-state road traffic, intra city traffic, international road traffic, possible influx of elites from abroad, preponderance of high risk political elite, likelihood of religious gathering, likelihood of other social gatherings, and proximity to existing COVID-19 test centers. These were also tested as predictors of COVID-19 spread using multiple regression analysis.

the results show that 6 States - Lagos, Kano, Katsina, Kaduna, Oyo and Rivers - and the Federal Capital Territory have very high vulnerability, 17 states have high vulnerability and 13 states have medium vulnerability to COVID-19 transmission. Several drivers show a strong association with COVID-19 with the coefficient of correlation ranging from 0.983 - 0.995. The regression analysis indicates that between 96.6 and 99.0 percent of the total variation in the COVID-19 infections across Nigeria can be explained by the predictors.

the spatial pattern of infection across the states are substantially consistent with the predicted pattern of vulnerability.

the spatial pattern of infection across the states are substantially consistent with the predicted pattern of vulnerability.

cancer is a major cause of death in the world. The purpose of this study is to evaluate the epidemiological, clinical, therapeutic and prognostic features of cancers of the pancreas (CP) at the National Hospital and University Center of Cotonou.

we conducted a cross-sectional descriptive and analytical study with a prospective and retrospective data collection over a period of ten years, from 1 October 2009 to 31 October 2019.

out of 15.102 hospitalizations, we identified 72 cases of CP, reflecting a hospitalization rate of 0.5%. The average age of patients was 59 years. The sex-ratio (H/F) was 1.5. The main reason for consultation was abdominal pain. More than half (51.4%) of patients had metastatic tumor at the time of diagnosis. CDK inhibitor Histological evidence of adenocarcinoma was only reported in 15.1% of cases. The rate of operable patients was 37.5% while the rate of resectable patients was 2.7%. Palliative chemotherapy was given to 13.9% of patients. The average cost of treatment was 955.882,4 FCFA (23.9 times the Guaranteed Interprofessional Minimum Wage in Benin). Median overall survival was 6 months. Mortality rate was 86.9% (53/61), survival rate at one year was 31.4%, and zero at five years. Palliative surgery (p = 0.021) and chemotherapy (p = 0.023) improved patient survival.

cancer of the pancreas, due to its non-specific signs and insidious outcome, is often diagnosed at a late stage. A metastatic tumor and the limited individual and institutional therapeutic possibilities lead to more pejorative prognosis.

cancer of the pancreas, due to its non-specific signs and insidious outcome, is often diagnosed at a late stage. A metastatic tumor and the limited individual and institutional therapeutic possibilities lead to more pejorative prognosis.

more cases of COVID-19 continue to be reported in Nigeria. The level of knowledge could prompt individuals to take precautionary measures and reduce the spread. This study aimed to assess the knowledge of community members in Ibadan on COVID-19.

using a descriptive cross-sectional study design, an interviewer-administered semi-structured questionnaire was used to obtain information from adult community members. Multistage sampling methods were used to select respondents from four local government areas (LGAs). Knowledge scores of causes, mode of spread, signs and symptoms and preventive measures were computed. Scores above the mean were categorized as satisfactory. Bivariate chi-square tests and binary logistic regression were performed on respondents' characteristics and knowledge of COVID-19.

respondents interviewed were 480 with a median age of 32 years (range 18-80 years), and 191 (39.8%) aged between 25 and 34 years. Females were 275 (57.3%), 18 (3.8%) had never heard of COVID-19. The main source of information was radio 88.1% and television 54.3%. In all the knowledge domains 200 (43.3%) had satisfactory knowledge of COVID-19. Respondents in Ibadan North-West LGA had five times odds [OR=5.23 (95%CI=2.87-9.54)] of having satisfactory knowledge of COVID-19 while respondents in Ibadan North-East LGA had three times odds [OR=3.35 (95%CI=1.85-6.09)] compared to those in Ibadan South East LGA.

an even dissemination strategy of COVID-19 information across the communities is required. More sensitization and health education sessions should be broadcast on the radio and television. Regular COVID-19 broadcast is required to improve the knowledge level of community members.

an even dissemination strategy of COVID-19 information across the communities is required. More sensitization and health education sessions should be broadcast on the radio and television. Regular COVID-19 broadcast is required to improve the knowledge level of community members.Primary musculoskeletal echinococcosis is rare and accounts for 2-3% of the patients with hydatid disease. We report a case of giant primary hydatid cysts of the thigh and the gluteal region in an 82-year-old female, who presented with a painful multiple palpable mass. The diagnosis was confirmed by imaging and serology. Total resection was performed through an extended lateral approach of the thigh and intraoperative findings revealed infected giant hydatid cysts. The postoperative outcome was uneventful. Albendazole drug (400mg per day) was given for the next 3 months. At 6 months follow-up, the patient was satisfied with no complications or recurrence.