Exhaustive Sampling Research Articles

Health Service Procedures for BPJS Participants in the Inpatient Room of Lasinrang General Hospital, Pinrang Regency

Hospital services (RS), are an important public service and are needed in an effort to meet health demands. Services for the poor are one aspect implemented by health service providers such as hospitals through after-sales services by utilizing BPJS funds as operational service activities. The type of research used is a survey system with a descriptive design. The research population is all BPJS participant patients who utilize inpatient services during the study, as many as 101 people who are also research samples based on the exhaustive sampling method where the entire population is used as a sample. The results of the study showed that BPJS participants who utilized health services at Lasinrang General Hospital, Pinrang Regency were mostly in the 20-29 year age group (32.7%), more were women (63.4%) with junior high school education (46.5%) and more worked as farmers (24.8%), more BPJS participant patient admission procedures stated in the good category (69.3%), more doctor services stated in the good category (67.3%), more nurse services stated in the good category (65.3%) and more BPJS participant drug services stated in the good category (72.3%). The suggestion put forward in this study is the need to conduct training on excellent service in order to improve skills in providing services, especially to BPJS participants and treatment planning using the drug procurement method through distributors so that if the drug runs out, the distributor can be contacted and this will support the efficiency and effectiveness of drug procurement that meets the needs of patients, especially BPJS participants who utilize health services at the hospital.

Health Service Procedures for BPJS Participants in the Inpatient Room of Lasinrang General Hospital

Hospital services (RS), are an important public service and are needed in an effort to fulfill health demands. Services for the poor are one aspect implemented by health service providers such as Hospitals through after-sales services by utilizing BPJS funds as operational service activities. The type of research used is a survey system with a descriptive design. The population of the study was all BPJS participant patients who utilized inpatient services during the study, totaling 101 people who were also research samples based on the exhaustive sampling method where the entire population was sampled. The results of the study showed that BPJS participants who utilized health services at Lasinrang General Hospital, Pinrang Regency were mostly in the 20-29 year age group (32.7%), more were women (63.4%) with junior high school education (46.5%) and more worked as farmers (24.8%), more BPJS participant patient admission procedures stated that they were in the good category (69.3%), more doctor services stated that they were in the good category (67.3%), more nurse services stated that they were in the good category (65.3%) and more drug services for BPJS participant patients stated that they were in the good category (72.3%). The suggestion put forward in this study is the need to conduct training on excellent service in order to improve skills in providing services, especially to BPJS participants and treatment planning using the drug procurement method through distributors so that if the drug runs out, the distributor can be contacted and this will support the efficiency and effectiveness of drug procurement that meets the needs of patients, especially BPJS participants who utilize health services at the hospital.

Factors Affecting the Pattern of Health Service Receipt in Patients with Diabetes Mellitus at the Pangirkiran Health Center, Padang Lawas Utara Regency

Background: Diabetes Mellitus (DM) is a global health problem, with an increasing prevalence rate. In Padang Lawas Utara Regency, especially at the Pangirkiran Health Center, DM sufferers face various obstacles in receiving optimal health services. Objective: The study aims to analyze the factors that affect the pattern of receiving health services for people with diabetes mellitus. Methods: This type of quantitative research with a cross sectional study design was conducted at the Pangirkiran Health Center, Padang Lawas Utara Regency. The population and sample were all 136 patients with diabetes mellate with an exhaustive sampling technique. Data collection using a research questionnaire. The data was processed and analyzed using chi-square tests and logistic regression as well as the presentation of data with tables accompanied by explanations. Results: The results of the study prove that knowledge (p=0.007) and socio-cultural (p=0.008) have a significant effect on the pattern of receiving health services for people with diabetes mellitus. The most influential variable is Exp knowledge (B)=4.942. Conclusion: The conclusion was obtained that knowledge factors about diabetes mellitus and socio-culture play a significant role in determining the pattern of health service receipt. Therefore, it is important for the Pangirkiran Health Center to improve health education programs, improve access to services, and involve families in the process of managing diabetes mellitus. This research is expected to provide policy recommendations to improve the quality of health services for people with diabetes mellitus in the region.

A new discrete-geometry approach for integrative docking of proteins using chemical crosslinks.

The structures of protein complexes allow us to understand and modulate the biological functions of the proteins. Integrative docking is a computational method to obtain the structures of a protein complex, given the atomic structures of the constituent proteins along with other experimental data on the complex, such as chemical crosslinks or SAXS profiles. Here, we develop a new discrete geometry-based method, wall-EASAL, for integrative rigid docking of protein pairs given the structures of the constituent proteins and chemical crosslinks. The method is an adaptation of EASAL (Efficient Atlasing and Search of Assembly Landscapes), a state-of-the-art discrete geometry method for efficient and exhaustive sampling of macromolecular configurations under pairwise inter-molecular distance constraints. We provide a mathematical proof that the method finds a structure satisfying the crosslink constraints under a natural condition satisfied by energy landscapes. We compare wall-EASAL with IMP (Integrative Modeling Platform), a commonly used integrative modeling method, on a benchmark, varying the numbers, types, and sources of input crosslinks, and sources of monomer structures. The wall-EASAL method performs better than IMP in terms of the average satisfaction of the configurations to the input crosslinks and the average similarity of the configurations to their corresponding native structures. The ensembles from IMP exhibit greater variability in these two measures. Further, wall-EASAL is more efficient than IMP. Although the current study uses crosslinks, the method is general and any source of distance constraints can be used for integrative docking with wall-EASAL. However, the current implementation only supports binary rigid protein docking, i.e., assumes that the monomer structures are known and remain rigid. Additionally, the current implementation is deterministic, i.e., it does not account for uncertainties in the crosslinking data beyond using distance bounds. Neither of these appears to be a theoretical or algorithmic limitation of the EASAL methodology. Structures from wall-EASAL can be incorporated in methods for modeling large macromolecular assemblies, for example by suggesting rigid bodies or restraints for use in these methods. This will facilitate the characterization of assemblies and cellular neighborhoods at increased efficiency, accuracy, and precision. The wall-EASAL method is available at https://bitbucket.org/geoplexity/easal-dev/src/Crosslink and the benchmark is available at https://github.com/isblab/Integrative_docking_benchmark.

Do repeated government infusions help financial stability? Evidence from an emerging market

While government led bank capital infusions in US and other developed markets have been usually contingent an external shock or crisis episode, India presents a unique setting where significant capital infusions happen annually to stabilize the weak balance sheets of undercapitalized government owned public sector banks. Such “repeated” capital infusions can either better engender financial stability, given the timely government interventions; or create instability arising from possible moral hazard concerns. "Do such repeated government capital infusions lower banks’ financial risks and improve financial stability?” We shed light on the question through the lens of capital infusions in the Indian market. Based on the exhaustive sample of government capital infusions into public sector banks for the period 2008–18, we find robust evidence that capital infusions are associated with economically significant higher default, capital shortfall and network risks post-infusion, signaling a moral hazard problem, where treated banks may assume more risky investments.

Road Traffic Crash-Related Musculoskeletal Injuries in Bafoussam, Cameroon: Exploring the Gaps in Physiotherapy Access and Utilization: A pilot study

Background: Road traffic crashes worldwide result in significant morbidity and mortality, with musculoskeletal injuries often neglected in primary management. This study aims to investigate the prevalence and management of Road Traffic Crash-Related Musculoskeletal Injuries (RTCMI) in Bafoussam, Cameroon. Methods: We conducted a prospective cross-sectional study in Bafoussam's hospital emergency units from January to June 2024. Using an exhaustive sampling, we enrolled 120 road traffic traumatic victims who provided informed consent to participate in the study. We excluded patients unable to communicate due to trauma status. Data analysis employed Excel 2016 with a 95% confidence interval. Results: Our study revealed a RTCMI prevalence of 73%, with fractures being the most common injury (80%). Notably, physiotherapy was not prescribed in primary management, and only 11% received Physiotherapy prescriptions in secondary care. A mere 17% of respondents requested physiotherapy, citing prescription failure (100%), lack of knowledge (83.6%), preference for traditional treatment (21.9%), and high costs (2.7%) as barriers. Conclusion: This study highlights the need for further research into RTCMI management and physiotherapy integration in Cameroon. Our findings suggest significant gaps in prescription, awareness, and accessibility, emphasizing the importance of scaling up this study to inform healthcare policy and practice.

High-resolution parametric embodied impact configurator for PV and BIPV systems

To fully analyze the potential of PVs in achieving sustainable energy goals, careful consideration of the life cycle including the embodied impact is needed. Despite the existence of various life cycle inventories for PV modules, there remains a lack of structured and detailed data to enable easy comparison across different technology configurations. Such data is crucial for identifying the components with the highest environmental impact and further optimization. This data gap is an obstacle to informed decision-making processes when evaluating PV designs. The goal of this study is to develop a harmonized, modular database that captures the environmental impact of various PV systems in high resolution. It includes the selection of cell technology, electrical components, frame materials, and the location of production. The environmental assessment includes 14 impact categories. Additionally, a web-based configurator is available, allowing users to quickly estimate the environmental impact of custom PV panels. Through exhaustive sampling of different configurations, the study demonstrates that the Global Warming Potential of a PV panel can range from 10 to 380 kgCO2eq/sqm. The results of this study can support architects, engineers, and planners in estimating the embodied impact of the PV systems, leading to more informed and environmentally conscious design decisions.

A targeted gene phylogenetic framework to investigate diversification in the highly diverse yet geographically restricted red devil spiders (Araneae, Dysderidae).

The family Dysderidae is a highly diverse group of nocturnal ground-dwelling and active-hunter spiders. Dysderids are mostly restricted to the Western Palearctic, and particularly rich and abundant around the Mediterranean region. Interestingly, the distribution of species richness among its 24 genera and three subfamilies is highly biased-80% of its 644 documented species belong to just two genera, Dysdera (326) and Harpactea (211). Dysderidae provides an excellent study case for evolutionary and ecological research. It includes cases of trophic specialization, which are uncommon among spiders, and exhibit other remarkable biological (e.g. holocentric chromosomes), behavioural (e.g. cryptic female choice), evolutionary (e.g. adaptive radiation) and ecological features (e.g. recurrent colonization of the subterranean environment). The lack of a quantitative hypothesis on its phylogenetic structure has hampered its potential as a testing ground for evolutionary, biogeographical and ecological hypotheses. Here, we present the results of a target, multi-locus phylogenetic analysis, using mitochondrial (cox1, 16s and 12s) and nuclear genes (h3, 28s and 18s), of the most exhaustive taxonomic sample within Dysderidae (104 spp.) to date and across related families (Synspermiata) (83 spp.). We estimate divergence times using a combination of fossil and biogeographic node calibrations and use this timeline to identify shifts in diversification rates. Our results support the monophyly of the Dysderidae subfamilies Rhodinae and Dysderinae but reject Harpacteinae as currently defined. Moreover, the clades recovered within Harpacteinae do not support its current taxonomy. The origin of the family most likely post-dated the break-up of Pangea, and cave colonization may be older than previously considered. After correcting for the taxonomic artefacts, we identified a significant shift in diversification rates at the base of the genus Dysdera. Although the unique coexistence of specialist and generalist diets within the lineage could be suggested as the potential driver for the rate acceleration, further quantitative analyses would be necessary to test this hypothesis.

Clarification of the distribution, conchological diversity, and taxonomic status of the Iberian snail Iberus globulosus C.R. Boettger, 1913 (Gastropoda: Stylommatophora: Helicidae)

The taxonomic status of Iberus globulosus has been unsatisfactorily resolved since its original description, but in 2008 a molecular phylogenetic study of the genus Iberus suggested that it could be a valid species. However, limited information on both its geographic distribution and its conchological variability has made it difficult to properly delineate the species. Our exhaustive sampling throughout the potential area of its geographic distribution and the morphological study herein, together with pre-existing genetic evidence, allow us to confirm the validity of I. globulosus. Consequently, we improve the characterization of I. globulosus by redescribing it. Additionally, we provide information on the potential for hybridization among I. globulosus and geographically and phylogenetically close congeneric species.

Unbiased process capability estimation for autocorrelated data using exhaustive systematic sampling

AbstractIt is well known that process control index estimators are inflated when naively applied to positively autocorrelated data. The autocorrelation is a nuisance and not a feature that is captured in the process capability indices. This paper proposes exhaustive systematic sampling to create a pooled variance estimator that replaces the biased estimator of the process data standard deviation when data are autocorrelated. The proposed method is effective because the observations within a systematic sample are spread out in time and should be less correlated with each other as a result. It is similar to Bayesian thinning as a strategy for reducing the impact of autocorrelation except no observations are dropped. Properties of estimated process control indices are derived using quadratic forms and large sample theory that is nonparametric in the sense no distribution or time series model is assumed. Approximately unbiased estimates can be achieved for sufficiently large systematic sampling interval. The proposed method is compared to the time series method in a simulation study that demonstrates similar performance. The proposed method is applied to two examples that use because the target is not the midpoint of the specification limits and the mean differs from the target.

Accurate and Efficient Conformer Sampling of Cyclic Drug-Like Molecules with Inverse Kinematics.

Identification of all of the influential conformers of biomolecules is a crucial step in many tasks of computational biochemistry. Specifically, molecular docking, a key component of in silico drug development, requires a comprehensive set of conformations for potential candidates in order to generate the optimal ligand-receptor poses and, ultimately, find the best drug candidates. However, the presence of flexible cycles in a molecule complicates the initial search for conformers since exhaustive sampling algorithms via torsional random and systematic searches become very inefficient. The devised inverse-kinematics-based Monte Carlo with refinement (MCR) algorithm identifies independently rotatable dihedral angles in (poly)cyclic molecules and uses them to perform global conformational sampling, outperforming popular alternatives (MacroModel, CREST, and RDKit) in terms of speed and diversity of the resulting conformer ensembles. Moreover, MCR quickly and accurately recovers naturally occurring macrocycle conformations for most of the considered molecules.

DyMMM-LEAPS: An ML-based framework for modulating evenness and stability in synthetic microbial communities

There have been a growing number of computational strategies to aid in the design of synthetic microbial consortia. A framework to identify regions in parametric space to maximize two essential properties, evenness and stability, is critical. In this study, we introduce DyMMM-LEAPS (dynamic multispecies metabolic modeling—locating evenness and stability in large parametric space), an extension of the DyMMM framework. Our method explores the large parametric space of genetic circuits in synthetic microbial communities to identify regions of evenness and stability. Due to the high computational costs of exhaustive sampling, we utilize adaptive sampling and surrogate modeling to reduce the number of simulations required to map the vast space. Our framework predicts engineering targets and computes their operating ranges to maximize the probability of the engineered community to have high evenness and stability. We demonstrate our approach by simulating five cocultures and one three-strain culture with different social interactions (cooperation, competition, and predation) employing quorum-sensing-based genetic circuits. In addition to guiding circuit tuning, our pipeline gives an opportunity for a detailed analysis of pockets of evenness and stability for the circuit under investigation, which can further help dissect the relationship between the two properties. DyMMM-LEAPS is easily customizable and can be expanded to a larger community with more complex interactions.

Evaluation of a Novel Battery-Operated Tumbler Device for Use in the Detection of Mouse Pathogens for Rodent Health Monitoring.

The search for alternatives to live animal sentinels in rodent health monitoring programs is fundamental to the 3Rs (Reduction, Replacement, and Refinement) of animal research. We evaluated the efficacy of a novel battery-operated tumbler device that rotates soiled bedding in direct contact with sample media against the use of exhaust sample media and soiled bedding sentinel (SBS) mice. Four rodent racks were used, each with 3 test cages: a cage with a tumbler device that rotated for 10min twice a week (TUM10), a cage with a tumbler device that rotated for 60min twice a week (TUM60), and a cage housing 2 female Crl:CD1(ICR) mice. Every 2 wk, each test cage received soiled bedding collected from all cages on each respective rack. In addition to soiled bedding, the tumbler device contained various sample collection media: a contact Reemay filter (3mo-cRF) that remained in the tumbler for the duration of the study, a contact Reemay filter (1mo-cRF) that was replaced monthly, adhesive swabs (AS) that were added at every biweekly cage change, and an exhaust Reemay filter located at the exhaust outlet of the cage. All analyses were performed by direct PCR for both sample media in the animal-free methods, and fecal pellet, body swab, and oral swabs were collected from sentinel mice. Out of 16 total pathogens detected, assessment of 1mo-Crf from both TUM10 and TUM60 cages detected 84% and 79% of pathogens, respectively, while SBS samples detected only 47% of pathogens. AS in TUM60 and TUM10 cages detected the fewest pathogens (24% and 13%, respectively). These results indicate that the novel tumbler device is an effective and reliable tool for rodent health monitoring programs and a suitable replacement for live animal sentinels. In this study, 1mo-cRF in TUM10 cages detected the highest number of pathogens.

Land tenure administration in Iraq: Quantitative analysis and a comprehensive evaluation

The present study underscores its novel methodology, employing a mathematical extrapolation as a guiding framework to investigate and scrutinize the Iraqi land tenancy system. Remarkably, this innovative approach stands distinct from preceding research endeavors. Notably, its application holds potential for facilitating a comprehensive inquiry into land tenure management facets across in Iraqi jurisdictions. Nevertheless, situated within a milieu characterized by volatility, an unfavorable investment climate, and a feeble private sector, the applicability of the policy's approach has been restricted. The land tenure sector has, regrettably, encountered challenges in assuming its anticipated role. Hence, a comprehensive investigation becomes imperative to evaluate plausible land tenure strategies and chart a prospective path forward for the nation a quest hitherto unexplored in extant scholarly works. To address this pressing issue, this paper endeavors to scrutinize and investigate successful interventions deployed by internal factors in response to predicaments akin to those presently challenging Iraqi system. In order to fulfill this objective, a set of negative interventions were used as indicators of the institutional aspects and how can elements of the existing system be assessed, thus the research methodology employed herein combines a numerical investigation of collected data derived from survey statistics with an exhaustive sample in Iraqi city, Al-Nasiriya. The outcomes of this investigation unveil the viability of endorsing enhancing the eroded trust in the Iraqi authorities, administrators of Iraqi land system have to add more details to the real picture of the existing system’ deficiency and then produce the effective solutions as a promising principal approach to be pursued within the contextual confines of Iraq.

Neural network-based source biasing to speed-up challenging MCNP simulations

Nuclear analysis of fusion facilities, especially in the context of ITER, is complex due to the need for precise modeling of complex geometry and radiation sources. Monte Carlo (MC) codes, such as MCNP, are used in this context due to their high precision and capability to deal with these cases. To speed up calculations, variance reduction (VR) techniques are crucial for carrying out the simulations in reasonable times. Particularly, the cases where only a small source phase space contributes significantly to the tally must be optimized by an exhaustive sampling of this phase space. This paper introduces a novel VR method for optimizing the calculation. This method obtains the histories that contribute most to the tally and uses this information for a neural network (NN) to sample the source´s phase space. Here we present a preliminary implementation of the method to study its viability in complex cases. The method's efficacy is demonstrated in a representative source-geometry configuration, significantly reducing computational time for the tally convergence. The promising results suggest applicability to more intricate ITER-like scenarios, prompting further development.

Awareness of standard precautions, circumstances of occurrence and management of occupational exposures to body fluids among healthcare workers in a regional level referral hospital (Bertoua, Cameroon)

BackgroundHealthcare workers (HCW) are exposed to infectious agents within biological materials including blood, tissues, other body fluids and on medical supplies, contaminated surfaces within the care delivery environment. Trends in occupational injuries are influenced by the level of awareness and observance of standard precautions (SP) among HCWs. This study aimed to assess the level of awareness of SP, exposure to body fluids, reporting pattern and management among HCWs in a Referral Hospital.MethodsThe present hospital-based cross-sectional study was carried out from 1st November 2020 to 31st May 2021. The exhaustive sampling method was used and a total of 120 consenting HCWs were invited to participate. A self-administered questionnaire addressed questions related to knowledge, experience, circumstances of exposure, reporting, management of occupational exposure to body fluids, hepatitis B vaccination status. Data were analyzed using R Statistic version 4.3.1. A p-value < 0.05 was considered significant.ResultsOut of the 120 participating HCWs, 104 (86.7%) reported at least one accidental exposure to body fluids over the last year. Men (aOR = 4.19; p = 0.277) and HCWs aged 35 and over (aOR = 4.11; p = 0.114) were more at risk for AEB even though the difference was not statistically significant. Nurses/midwives (aOR = 65.9; p-value = 0.0005) and cleaners (aOR = 14.7; p-value = 0.0438) faced the highest risk of exposure. Lack of knowledge (79%) and patient agitation (49%) were the most reported reasons for exposure. Half of the participants (53%) reported that they used a personal protective equipment during care. Face mask (59.2%) and gowns (30.8%) were the most commonly used PPE. Most HCWs (62%) did not report AEB. Half of the affected HCWs (50.8%) received a course of post-exposure antiretroviral therapy. Few HCWs (4.2%) were fully immunized against Hepatitis B.ConclusionsMost HCWs reported an accidental exposure to body fluids over the last year. Midwives and nurses were disproportionally affected socio-professional groups. Two-thirds of the AEB were undeclared. Only half of the participants reported using PPE systematically. Hepatitis B vaccination coverage was low. There is need to strengthen the observance of standard precautions, including preventive vaccination and the systematic reporting and management of AEB.

Microcomputed tomography as a diagnostic tool for detection of lymph node metastasis in non-small cell lung cancer: A decision-support approach for pathological examination “A pilot study for method validation”

BackgroundNon-small cell lung cancer (NSCLC) patients without lymph node (LN) metastases (pN0) may exhibit different survival rates, even when their T stage is similar. This divergence could be attributed to the current pathology practice, wherein LNs are examined solely in two-dimensional (2D). Unfortunately, adhering to the protocols of 2D pathological examination does not ensure the exhaustive sampling of all excised LNs, thereby leaving room for undetected metastatic foci in the unexplored depths of tissues. The employment of micro-computed tomography (micro-CT) facilitates a three-dimensional (3D) evaluation of all LNs without compromising sample integrity. In our study, we utilized quantitative micro-CT parameters to appraise the metastatic status of formalin-fixed paraffin-embedded (FFPE) LNs. MethodsMicro-CT scans were conducted on 12 FFPEs obtained from 8 NSCLC patients with histologically confirmed mediastinal LN metastases. Simultaneously, whole-slide images from these FFPEs underwent scanning, and 47 regions of interest (ROIs) (17 metastatic foci, 11 normal lymphoid tissues, 10 adipose tissues, and 9 anthracofibrosis) were marked on scanned images. Quantitative structural variables obtained via micro-CT analysis from tumoral and non-tumoral ROIs, were analyzed. ResultSignificant distinctions were observed in linear density, connectivity, connectivity density, and closed porosity between tumoral and non-tumoral ROIs, as indicated by kappa coefficients of 1, 0.90, 1, and 1, respectively. Receiver operating characteristic analysis substantiated the differentiation between tumoral and non-tumoral ROIs based on thickness, linear density, connectivity, connectivity density, and the percentage of closed porosity. ConclusionsQuantitative micro-CT parameters demonstrate the ability to distinguish between tumoral and non-tumoral regions of LNs in FFPEs. The discriminatory characteristics of these quantitative micro-CT parameters imply their potential usefulness in developing an artificial intelligence algorithm specifically designed for the 3D identification of LN metastases while preserving the FFPE tissue.

Slow and steady saves the race: molecular and morphological analysis of three new cryptic species of Iberus land snails from the Iberian Peninsula

The Iberian Peninsula constitutes a diversity hotspot with a high number of endemisms, where the land snail genus Iberus is likely the best example. Despite this, its species diversity is still debated as it holds several cryptic species. In the present paper, we use molecular evidence (mitochondrial DNA cytochrome oxidase subunit I) to clarify the position of I. ortizi and three new cryptic species that are described herein: I. giennensis, I. axarciensis and I. antikarianus spp. nov. For this, we sampled 281 sampling points to delimitate a comprehensive geographic mapping of these species. Moreover, we carried out a comprehensive morphometric analysis based on 3205 shells. Our findings show that, morphologically, the three described species overlap in the form of their shells, their morphologies being very similar to other close species with nearby distributions (I. ortizi, I. angustatus and I. marmoratus loxanus). Still, all these species are well-defined by genetic distances, but display allopatric distributions, suggesting that they evolved by allopatric speciation as a consequence of biogeographic isolation. Hence, our findings show insights into the evolution of land snails in southeastern Spain, with implications for their conservation, given that our exhaustive sampling shows that the three species described here have very limited distribution ranges, especially I. antikarianus sp. nov. Our study, moreover, implies an integrated approach to the study of the evolution of land snails, including the sampling of the complete geographic area occupied by the genus, genetic analysis to delimit the actual species range, as well as morphometric analyses to understand the phenotypic differentiation and adaptations of the three new species.

Low Birth Weight in the Gynecology-Obstetrics Department of the Commune I Reference Health Center in the District of Bamako

Low birth weight is an important public health indicator because of the strong association between birth weight and infant mortality and morbidity. The objectives were to determine the frequency of low birth weight, to describe the sociodemographic characteristics, to determine the risk factors associated with low birth weight and to determine the neonatal prognosis in the gynaecology and obstetrics department of the reference health center in Commune I of the Bamako district. Material and Methods: This was a cross-sectional, descriptive and analytical study in the department from 31 December 2020 to 30 June 2022. We carried out exhaustive sampling, taking into account all live newborns with a low birth weight. All newborns born in the department weighing between 500g and 2499g during the study period were included. Results: We recorded 4,292 births, 180 of which were low birth weight, giving an overall incidence rate of 4.2%. Of the 180 low birth weight babies, we found 111 cases of prematurity (61.7%) and 69 cases of hypotrophy (38.3%). We found that the proportion of low birth weight babies was higher in the young mothers in our study, at 60.5% for the under-19 age group. Our study showed that the extreme ages of the mother were a factor favouring or even predisposing to the occurrence of low birth weight. We noted a high frequency of primiparous women (38.7%) followed by multiparous women (32.5%). Other maternal risk factors included hypertension (8%) and a body mass index of less than 18.5% kg/m2 in 41.2% of cases. Half of the new borns (47.8%) weighed between [1501-2000g]. Among the transferred newborns, 53.3% received kangaroo mother care and 6.8% of the newborns died during the first thirty days of life. We recorded a mortality rate of 6.8%. Conclusion: Low birth weight is a public health problem because of its high prevalence and its harmful consequences, especially for infants.

Epidemiological Profiles of Acute Otitis Media at the Commune II Referral Health Center in the Bamako District

Acute otitis media is a very common condition in children under the age of 7, most of whom suffer their first episode before the first three years of life. Despite scientific advances in its therapeutic and preventive management, this condition remains frequent and cosmopolitan, particularly in otolaryngology (ENT) and pediatric wards. In view of the possibility of disabling complications, we set out to study the epidemiological and clinical profile of this condition for the first time in the ENT department of the Commune II Reference Health Centre in the District of Bamako, Mali. This is a descriptive, retrospective study, using routine consultation data from January to December 2022. Based on exhaustive sampling, we collected 568 cases of confirmed AOM, representing an incidence of 20.63%. Patient age ranged from 3 months to 83 years, with an average of 12.49 years. Overall, the 3-7 age groups predominated, with 30.63% of cases. However, patients under 2 years of age predominate in progressive forms of the various stages. This study shows that AOM is a frequent occurrence in our department, and highlights the need for good interdisciplinary networking between pediatricians and ENT specialists in the management of AOM, in order to avoid possible recurrences and functional sequelae.