Service de Pediatribe

Fès, Morocco

Service de Pediatribe

Fès, Morocco
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David A.,Service de Pediatribe | Timochenko A.,Service ORL | Prades J.-M.,Service ORL
Douleur et Analgesie | Year: 2012

The ENT pathology is frequent in primary care, adults and children, and often comes along with pain. The pains have a point of departure ORL are mostly in connection with viral infections, or bacterial and to affect the ear itself or to be projected. Patients very often fear carcinogenic pathology. The nurse who greets the patient can by inquiring identify not only the intensity (severe with acute stage), chronology (paroxystic, chronic) and associated signs (rhinologiques, cough, fever, general state, sleeping disorders, etc.) of pain but also the context: anxiety, fear for cancer pathology, and vascular headache. The nurse has to inform the patient, reassure the family and the circle of acquaintances in particular when it is about children. We shall limit ourselves to the most frequently encountered pathologies such as rhino-sinusal infections, ENT pathology, otitis and cancer pain. © 2012 Springer-Verlag France.

Since its recommendation by WHO, Oral Rehydration Solutions (ORS) contributed in reducing the rate of mortality due to acute gastroenteritis. In Madagascar, the rate of lethality imputed to gastroenteritis is about 3%. Rehydration can be performed either by using spoons which reliability is unsure because of parents' potential inobservance and child's refusal, or by nasogastric tube. The nasogastric tube may resolve these obstacles at the hospital. We realized a preliminary study to evaluate the efficacy and the safety of nasogastric tube and spoon administration of the ORS in rehydration of child with moderate post-gastroenteritis dehydration. This is an open comparative study realized in the Pediatric Unit at the Joseph-Raseta- Befelatanana Hospital from the 21 January to 21 May 2008. Main outcomes was the proportion of rehydrated children at 4 hours, other were: failure at 8 hours, duration and volume of SRO, side effects. Fifty-three children from 4-month to 4-year old among 1306 patients were recruited and forty-seven patients were included. Nine patients failed (4 children received ORS by spoon and 5 children by nasogastric tube). The use of spoon was more effective: 62.5% of the patients were rehydrated at the fourth hour versus 39.3% in nasogastric tube group (P = 0.04). Making debit constant presents difficulties in rehydration with nasogastric tube (44.4 %). Tolerance of nasogastric tube is generally good but 16.7% children get out their tube during this study. No ORS' inhalation was observed with both routes. No false passage or tube or ORS rejection was recorded in both techniques. This study shows that using spoon to rehydrate is more effective for the rehydration of moderate dehydration. The use of nasogastric tube needs more surveillance. © 2010 Société de pathologie exotique et Springer-Verlag France.

Ravelomanana T.,Service de Pediatribe | Rakotomahefa M.,Service de Pediatribe | Randrianaivo N.,Service de Pediatribe | Raobijaona S.H.,Service de Pediatribe | Barennes H.,Institute Francophone Of Medecine Tropicale
Bulletin de la Societe de Pathologie Exotique | Year: 2010

The parents 'educational conditions are one of the factors of health inequalities among children. During May 2009, the parents' instruction level of children admitted at the triage unit of a Pediatric Service in Antananarivo, Madagascar was evaluated and related to the severity of their children' health status and to the mode of reference. All the surviving children (from 2 months to 15 years old) were included in this study. Patients were classified by the IMCI guideline and we analyzed the educational level of their mothers. Each patient was classified as severe illness or without severe illness, according to IMCI algorithm. The quality of referring physician was recorded: public physicians, liberal physicians, nurses, or without referral. Among 296 children, 9 (3%) died before admission, 217 (75.6%) were included. Among them, 123 (56.7%) had a severe illness and 38,2% general signs of danger. The severity (92.3 versus 54.4%; P = 0.003), the number of severe dehydration (15.4 versus 3.9%; P = 0,027) and malnutrition (15.4 versus 4.4%; P = 0.039) were related with a poor parents educational level. The referral agents were mostly liberal physicians (56.7%), public physicians (26.7%) or nurses (1.8%). Mothers with higher educational level preferred to attend liberal physicians (58 versus 41.9%; P = 0.1). The reference delay was shorter if there was a severe illness (6.41 versus 19.6 days; P > 0.000) or no medical referral (51.1 versus 24.4%; P > 0.000). Despite the fact that access to hospital care was respectful of a two-step process (85.3%), the number of patients with severe illness was high among families with low educational level. Theses results suggest to educate in priority the mother with low education, in order to recognize the general signs of danger and facilitate early first health care. © 2010 Société de pathologie exotique et Springer-Verlag France.

Hassani M.A.,Laboratoire Dhematologie | Alami M.,Laboratoire Dhematologie | Baba A.F.,Laboratoire Dhematologie | Lahlou H.,Laboratoire Dhematologie | And 4 more authors.
Annales de Biologie Clinique | Year: 2010

The Niemann Pick disease is a rare lysosomal storage disease responsible for numerous cytological abnormalities of blood cells and bone marrow. The diagnosis requires enzymatic dosages, which can be long and difficult. In this context, the detection of inconstant cytologic anomalies in blood and bone marrow smears, allowing a rapid screening, is an important step in the diagnostic approach. We report the case of a 6 year-old child who presents with abdominal distension; medullogram was performed and revealed the presence of vacuolated cells overload. Correlated with clinical and biochemical data, medullogam results confirmed the diagnosis of type A Niemann Pick disease.

Sackou Kouakou J.G.,University Of Cocody | Oga S.,University Of Cocody | Claon S.,University Of Cocody | Bama M.,Institute National DHygiene | And 3 more authors.
Sante Publique | Year: 2012

A health survey on access to water and a chemical and bacteriological analysis were conducted between May and October 2010 on 200 tanks of drinking water in 669 households in a peri-urban area of Abidjan. The results show that 70% of the population used piped water and that 64% of the population used approximately 20 litres of water per person per day. The study found that households that used alternative sources of water spent more than those that used piped water (p < 0,001). The study also found that 75.6% of the surveyed households stored water. The survey showed that 81% of the samples contained coliforms and 42.5% contained Escherichia coli. The presence of bacteria can be explained by the large quantities of water stored in open containers (i.e. containers without lids). Basic water supply combined with health education and safe water storage containers are needed. © S.F.S.P. Tous droits réservés pour tous pays.

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