Vol 2 (2020)

Published: 2020-12-31

Abstract views: 1470   PDF downloads: 818  

Page 44-51

Maternal knowledge and practices regarding childhood acute respiratory infections in Lubumbashi, Democratic Republic of Congo

blankpage Aubin Ndjadi Wembonyama Kasongo, Olivier Mukuku, Gray A-Wakamb Kanteng, Mick Ya-Pongombo Shongo, André Kabamba Mutombo, Albert Mwembo-A-Nkoy Tambwe, Dieudonné Tshikwej Ngwej, Stanis Okitotsho Wembonyama, Oscar Numbi Luboya

Introduction: Acute respiratory infections (ARIs) are a public health problem in the Democratic Republic of Congo (DRC) and cover a range of infections, from the common cold to pneumonia. ARIs are the leading cause of death in children under-5, with the majority of deaths occurring in developing countries. 
Objective: To assess the knowledge and home-based practices used by mothers of children under-fives during episodes of ARI. 
Methods: A cross-sectional study was carried out among mothers of children under-five who were selected in Lubumbashi (DRC). A pre-tested questionnaire administered by researchers was used for data collection. 
Results: Of the 582 mothers interviewed, the majority had a good knowledge of the symptoms (87.46%), danger signs of severe ARIs (95.02%) and a good knowledge of the modes of transmission of ARIs (68.73%). Knowledge level was significantly associated with age and education level regarding modes of transmission. Three hundred and sixty-eight (63.23%) mothers indicated that they use traditional remedies: 252 (43.30%) apply palm oil to their children’s noses and as many mothers (n = 252; 43.30%) apply mentholatum ointment to the nose. Almost all of the mothers (n = 579; 99.48%) indicated that they dress the child with several layers of clothes. Oral self-medication was used by 575 mothers (98.80%). 
Conclusion: The mothers’ knowledge of modes of transmission, symptoms and danger signs of ARIs was good in the community studied in Lubumbashi. Knowledge level was associated with age and level of education regarding modes of transmission.

Abstract views: 1430   PDF downloads: 824  

Page 38-43

Thyroid dysfunction in Congolese subjects with Down syndrome

blankpage Toni Kasole Lubala, Olivier Mukuku, Tony Kayembe-Kitenge, Prosper Muenze Kayamba Kalenga, Prosper Lukusa Thilobo, Oscar Numbi Luboya, Jean Vanderpas

Objective: The present study aims to assess the proportion and the pattern of thyroid dysfunction in a population of Congolese subjects with Down Syndrome.
Methods: A total of 34 subjects with Down syndrome were recruited from Lubumbashi (Democratic Republic of Congo). Thyroid morphology was assessed by sonography. Serum T3, T4, FT4, TSH, Thyroglobulin, Thyroid peroxidase antibody (TPOAb) and antithyroglobulin antibody (TgAb) were measured.
Results: The mean age of the patients was 13 years (range: 3 and 47 years). Of 34 Down syndrome subjects, 6 cases (17.6%) were found to have subclinical hypothyroidism. No patient had hyperthyroidism. Among 29 subjects with a thyroid ultrasound imaging, 25 patients (86.2%) were found to have morphological abnormalities of the gland. Regarding thyroid autoantibodies, TPOAb was positive in 1 case (2.9%) and TgAb was positive in 1 case (2.9%).
Conclusion: The results were compared between patients with hypothyroidism and with normal thyroid function. There was no statistical difference in terms of age, sex, nutritional status, antibody levels and thyroid volume between these two groups. Conclusions: In our series, the proportion of hypothyroidism is relatively important but it remains largely under the prevalence reported in international studies.

Abstract views: 1415   PDF downloads: 887  

Page 32-37

Deciding whether to treat isolated mild dysplasia in infantile DDH: Identifying factors in decision making

blankpage Craig R Louer, James D Bomar, Jessica L Hughes, Scott J Mubarak, Dennis R Wenger, Vidyadhar V Upasani

Purpose: There is significant variability in brace treatment indications for infantile acetabular dysplasia in the absence of hip dislocation or subluxation. This study’s purpose was to evaluate characteristics of treated and untreated patients in our practice.
Methods:  A retrospective chart review was performed of patients aged 0-12 months who were referred to orthopedics with concern for DDH. Demographic and clinical information, as well as provider and radiographic information were recorded for analysis. Five surgeons were independently asked to review de-identified radiographs and note which subjects warranted treatment. A consensus diagnosis of “dysplasia”, “no dysplasia”, or a lack of consensus were considered as independent variables. Univariate and Classification and Regression Tree (CART) analysis was performed to determine predictors of treatment.
Results:  Mean acetabular inclination (30.6º vs. 28.2º; p=0.006) and the incidence of abnormal abduction (p=0.002) were higher for the group that was treated for dysplasia. CART analysis showed that patients with a consensus diagnosis of radiographic dysplasia were more likely to receive treatment than those without consensus, or a consensus of no dysplasia (p<0.001). If consensus was not reached, then abnormal abduction on exam was the next strongest predictor of treatment (p<0.001). Radiographic impression, which was the primary determinant of treatment, exhibited only fair intrarater and interrater reliability.
Conclusions:  We studied factors that led to the diagnosis and treatment of DDH in an infant population. We observed that radiographic impression and abnormal abduction on exam were the only reliable factors predictive of treatment among our practice.

Abstract views: 3382   PDF downloads: 1424   HTML downloads: 852  

Pages 29-31

Targeted molecular therapy (modified RIST regimen) in relapsed high risk stage IV neuroblastoma: two cases report

blankpage Paolo Indolfi, MD, Selim Corbacioglu, MD, Silverio Perrotta, MD, Francesca Rossi, MD, Antonio Marte, MD, Elvira Pota, MD, Martina Di Martino, MD, Daniela Di Pinto, MD, Cristiana Indolfi, MD, Fiorina Casale, MD

The prognosis for children with recurrent or refractory neuroblastoma remains a significant clinical challenge, and currently there are no known curative salvage regimens. In this paper we investigated the effect of imatinib with rapamycin and the chemotherapeutic agents temozolomide and irinotecan. We treated two children with recurrent neuroblastoma with this so called RIST protocol. Both patients, off therapy for 15 and 31 months, respectively are well, and developing normally, without any complications. These findings suggest that a combination regimen of RIST may provide a therapeutic benefit with a favorable toxicity profile to a unfortunate subset of patients with neuroblastoma.

Abstract views: 2538   PDF downloads: 1116   HTML downloads: 285  

Pages 28

What is damaging our tissues and lives?

blankpage Mario Ciampolini

Viruses, parasites and bacteria destroy cell and tissues by direct action and indirectly eliciting inflammation. Allergy and insulin resistance worsen and maintain inflammation. Blood glucose (BG) does this directly (?) and provoking unwanted reflexes. Lipids, mainly cholesterol sustain vascular diseases (or only mark damages?). Hypertension signals and contributes to vascular diseases. I prefer to think to a unique final way of damaging: the immune mechanisms of damage. Immune cells and antibodies are predisposed to destroy molecules or structures that are born outside the human body and are demolished in all tissues......