Regional Hospital Center Research Articles

Predictors of adverse outcome in the first and second waves of the COVID-19 pandemic: results from a UK centre.

Background/Aims: Data concerning differences in demographics/disease severity between the first and second waves of COVID-19 are limited. We aimed to examine prognosis in patients presenting to hospital with COVID-19 amongst different ethnic groups between the first and second waves in the UK.Methods: In this retrospective cohort study, we included 1763 patients presenting to a regional hospital centre in Leicester (UK) and compared those in the first (n = 956) and second (n = 807) waves. Admission National Early Warning Scores, mechanical ventilation and mortality rate were lower in the second wave compared with the first.Results: Thirty-day mortality risk in second wave patients was approximately half that of first wave patients [adjusted hazard ratio (aHR) 0.55, 95% confidence interval (CI) 0.40–0.75]. In the second wave, Black patients were at higher risk of 30-day mortality than White patients (4.73, 1.56–14.3). Conclusion: We found that disporportionately higher risks of death in patients from ethnic minority groups were not equivalent across consecutive waves of the pandemic. This suggests that risk factors for death in those from ethnic minority groups are malleable and potentially reversible. Our findings need urgent investigation in larger studies.

Prevalence of Iron Deficiency Anemia among Moroccan Pregnant Women

Background: Iron deficiency anemia in pregnant women is a serious public health problem, especially in developing countries. Aim: The objective of this study is to determine the prevalence of iron deficiency anemia and its associated factors during pregnancy in the south of Morocco. Methods: A cross-sectional study was carried in the regional Hospital Center Hassan II (RHC) from April to august 2021 in all the pregnant women coming for consultation in the maternity service. 500 pregnant women were randomly recruited for the study. A complete blood count and serum ferritin was performed in every case. They have been the subjects of a questionnaire containing their background and health data. The analysis of our data was done by the IBM SPSS Statistics 25 software. Results: The prevalence of iron deficiency anemia was 20% with a CI of (44.7% - 53.5%). The most affected age group was 25 to 35 years with a rate of 42.86%. The majority of women had mild anemia (84.61%) followed by moderate anemia (11.54%) and severe anemia (3.85%). 57.14% of the anemic pregnant women were primigravida. The results of serum ferritin made it possible to identify 70% of women deficient, with a dominance of normocytic normochromic anemia. The influence of geographic origin and place of birth was not significant. Conclusion: The prevalence of iron deficiency anemia is more or less low in our study. However, there is a high prevalence of iron deficiency and anemia during pregnancy. Statistically, there was no significant association between iron deficiency anemia and the various parameters studied, such as age, parity, origin and place of birth.

The Epidemiological Profile of Acute Peritonitis and Sensitivity to Antibiotics, about 167 Cases, in the General Surgery Department of the Amissa Bongo Regional Hospital Center in Franceville, Gabon

The Epidemiological Profile of Acute Peritonitis and Sensitivity to Antibiotics, about 167 Cases, in the General Surgery Department of the Amissa Bongo Regional Hospital Center in Franceville, Gabon

The Epidemiological Profile of Acute Appendicitis, about 124 Cases, in the General Surgery Department of the Amissa Bongo Regional Hospital Center in Franceville, Gabon

Acute appendicitis is an acute inflammation of the appendix. It is a surgical emergency. It was a prospective, descriptive and analytical study, between September 2015 and October 2021, focusing on acute appendicitis. It is seen mainly in young subjects and in children, but not exclusively. Its diagnosis is essentially clinical. These were 124 patients operated on for acute appendicitis, with a male predominance: 78 men (62.90%) against 46 women (37.10%). The majority of patients came from Franceville (n = 66) 53.22%. The average age was 29.4 years (extremes 4 years and 54 years). The average admission time was +5.16 or -5.58 hours. Abdominal pain was the main reason for consultation. Physical signs were dominated by MAC Burney sign positivity in 91.1% of cases. Faced with certain doubtful cases, we requested an abdominal ultrasound. Phlegmonous appendicitis was the most frequent (n = 47) 45.96%. The ileocecal localization represented (n = 82) 66.12%, and other particularities in particular: Claudius AMIAND (n = 6), an appendicular duplication, appendicitis and pregnancy a case of crural appendicitis. Conventional appendectomy with burial by Mac Burney was the most used technique (n = 119) 95.42%. Anatomy pathology was rarely performed. The postoperative course was simple in 95.4% of cases. The average stay in inpatient surgery was 4.8 days. Isolated or combined antibiotic therapy was the rule. Postoperative follow-up at 1 month was systematic. Parietal suppuration was the main complication.

Predictors of Mortality in Chronic Kidney Disease Patients with Covid-19 in Togo

Background: Coronavirus disease mortality is high in people with chronic kidney disease. Method: we present the characteristics and factors associated with mortality of patients hospitalized for Covid-19 and with chronic kidney disease in a descriptive and analytical cross-sectional study of CKD patients admitted to the Lomé Commune Regional Hospital Center (CHR-LC) from March 2020 to August 2021. Results: A total of 127 patients met our inclusion criteria. We found a mortality rate of 48.8% in Lomé (Togo). Factors associated with this mortality in our study were severity of Covid-19 (p < 0.0001), length of hospital stay (p < 0.0001), pulse oxygen saturation (p < 0.0014), GFR stage (p = 0.0003), existence of hyperglycemia (p = 0.0036) and use of corticosteroids (p = 0.0336). Conclusion: Mortality is very high in CKD patients with Covid-19.

Asthma in Morocco: Retrospective Analysis of Case Characteristics reported by Hospital Units

Asthma is a serious public health problem. This study aimed to identify the characteristics of asthma cases reported by Agadir's Souss-Massa Regional Hospital Center (SMRHC). A retrospective analysis was carried out at the SMRHC's pneumology and paediatrics departments in 2019. As data support, reporting records and a data collection worksheet were used. This year, 141 cases were reported. The highest frequencies were observed in February (21.9%) and April (26.6%). Both males and females were affected (sex ratio Male/Female = 0.98). The asthmatics were, on average 40.7 ± 25.1 years old. The majority of the cases are from areas that are easily accessible for medical consultation at the SMRHC. To obtain more accurate knowledge and contribute to the research, related studies should be undertaken on this topic. Our findings, we hope, will act as a foundation for future research into improving the case registration system (digital support) and upgrading patient data in accordance with WHO and GINA guidelines.

Prevalence and Factors Associated with Renal Dysfunction Among hiv Infected Children Attending hiv clinic at Dodoma Referal Regional Hospital and Makole health Centre.

Background: Human Immunodeficiency Virus infection (HIV) is a multisystem disease that contributes to significant morbidity. Renal involvement is reported to be common among patients with HIV. This study was carried out to determine renal involvement using simple bedside tests combined with ultrasonography examination. Methodology: A crossectional Study design was carried out and included, The Total number of 236 Children’s Infected with HIV were Recruited at Dodoma Regional Referral Hospital and Makole Urban Health Centre. During the study Population included HIV/AIDS Positive Children male and Female were aged less than 15 years whether on or not on HAART regimen. The study duration was carried out for the period of six months (6 months). Results: The prevalence and factors associated with Renal dysfunction in HIV infected Children were among boys and girls Recruited infected children’s were 52.5% and 47.5% Respectively and were by those accounting below 5 years were 39.8% and among above of Five years of the age recruited were 60.2% .The association of the number of the infected children with renal dysfunction prevalence was 56% and The association between HIV with the renal dysfunction with the estimated eGlomerular Filtration (eGFR) of below &lt;60ml/min of the patient recruited below five years were 7.6% and above 5&lt; Years of Age recruited were 80.8% with significantly P Value &lt;0.001.Enrolled Children with Proteinuria Investigated accounted for the 20.5 % .With this similar study that was conducted at MNH Fredrick et al which correlated with our study and findings. Proportional of the children with anemia account for Renal Dysfunction was 91.7% with significance P Value &lt; 0.019. Conclusion: The prevalence of renal dysfunction among recruited patients were 56% and this finding are higher compared to previously research study. The association of Renal Dysfunction that were included in the study showed proportional with the association of High viral load, low CD4 count, Drug adherence, Malnutrition, Comorbidities anemia and over all HIV Human Immuno deficiency Staging.

Audit of maternal deaths at the Saint Louis regional hospital from 2017 to 2019

Objective: To audit maternal deaths at the regional hospital center of Saint-Louis. Materials and methods: This was a retrospective cross-sectional study of all maternal deaths that occurred between January 1, 2017 and December 31, 2019 at the Saint-Louis regional hospital center. Data were entered on EXCEL 2013 software. Analysis was performed on Epi Info version 3 software. Results: During our study, 73 cases of maternal death were collected. Maternal mortality was 520 per 100 000 live births. The mean age of the patients was 28.1 years±6.8. Multiparous women accounted for 43.8% and nulliparous women for 1.3%. The causes of maternal death were obstetric hemorrhage (28.77%), hypertension and its complications (20.55%), labour dystocia (15.07%) and anemia (6.85%). Direct obstetric causes of death were responsible for 64.38% of cases and indirect obstetric causes were seen in 35.62%. Death occurred postpartum in 68% of cases, during pregnancy in 25% and during labor in 7%. Death was preventable in 77.5% of cases. Conclusion: Maternal mortality is a real health problem in our practice. It affects young women. Indirect causes of death are becoming more significant causes of death in our practice. Maternal mortality is avoidable in the majority of cases.

Appendicular duplication revealed during peritonitis, about one case at the Amissa BONGO Regional Hospital Center of Franceville (CHRABF) Gabon

Appendicular duplication revealed during peritonitis, about one case at the Amissa BONGO Regional Hospital Center of Franceville (CHRABF) Gabon

Severe Preeclampsia Epidemiological, Diagnostic, Therapeutic and Prognostic Aspects at the Thies Regional Hospital Center about 443 Cases

Objectives: Are to study the epidemiological, diagnostic, therapeutic and prognostic aspects of severe pre-eclampsia in the Obstetrics Gynecology Department of the Regional Hospital of THIES. Materials and Methods: This were a prospective, descriptive and analytical study of patients received for PES at the Maternity Department of the Regional Hospital of Thies between June 20, 2015 and June 20, 2017. We studied the diagnostic, epidemiological, therapeutic and prognostic aspects. The data were entered and analyzed by the EPINFO software version 6.04dfr. In order to study the influence of certain prognostic factors, we used the comparison of proportions and the Chi-square test with a significance level of 0.05. Results: We recorded 443 cases of Severe Peclampsia (SEP) out of 15,744 pregnant women, i.e. a frequency of 2.81%. It represented 52.05% of all hypertensive states associated with pregnancy during the study and a frequency of 3.12% of deliveries. The typical epidemiological profile found was that of a young woman aged 20-24 (25.05%), married (91.19%), housewife (80.8%) from the commune of Thies (50.56 %), primiparous (52.37%), carrier of a single pregnancy (96.4%), followed in a health post (97.21%) and evacuated in 89.4% of cases. The time between admission and delivery was on average 3.85 ± 3.91 days with extremities ranging from 0 to 42 days. The main signs found were: headache (96.61%), hypertension with SBP ≥160/110mmHg (93.90%), edematous syndrome (90.29%), proteinuria on the test strip ≥ ++ (95.48%), hyper uricemia &gt;60mg/l (66.13%). Therapeutically, calcium channel blockers were the main antihypertensive agent used (99.32%). Magnesium sulfate was administered to almost all patients (97.29%). Corticosteroids were administered to 223 patients (50.23%). The blood transfusion had been done in 45 patients or 10.08%, and 05 of our patients had presented an acute renal failure requiring a transfer to Dakar for dialysis. Fetal evacuation was performed by Caesarean section in 49.88% of cases. Maternal complications were dominated by: eclampsia (24.78%), retro-placental hematoma (3.61%) and Hellp syndrome (3.61%). We recorded 18 cases of maternal death, i.e. a specific lethality of 4.06% and 69 cases of neonatal death, or a perinatal mortality rate of 4.87 per 1000 live births. On the fetal side, the main complications were fetal hypotrophy (51.46%) and prematurity (41.08%). The main factors of poor maternal prognosis were young age (20-24 years), primi gestity and primiparity. The fetal risk factors included prematurity and the low Apgar score.

Approach to Determine Crystalluria Influencing Factors in the Beni Mellal-Khenifra Area in Morocco, by Data Analysis

Urolithiasis presents an ascending prevalence in several countries around the world. The purpose of the present work is to achieve a fast and robust approach to the multiple factors influencing the chemical profile of human crystalluria and therefore in promoting the development of urinary calculi. From February to July 2018, 148 morning urine samples have been collected from 148 patients at the BeniMellal Regional Hospital Center in Morocco. An observation by Polarizing Light Microscopy allowed us to detect the chemical profile of crystalluria.A classification by the Principal Components Analysis (PCA) method has been applied to the individuals that are 148 crystalluria samples and to nine factors that are: ''gender'', ''age'', '' geographical area '', '' water quality'', ''water amount per day '', ''personal and family history'', ''urinary pH'', ''presence of crystals'' and ''chemical profile''. The first results of the principal components analysis (PCA) method shows that there are similarities between crystalluria samples and more or less strong correlations, between some of the nine factors that can influence crystalluria. The frequency of majority constituents in crystalluria is age dependent and oxalic-calcium is the frequent chemical species for both genders. The study of crystalluria would be an excellent laboratory test that brings many benefits for the diagnosis and management of renal pathologies of crystalline origin.One can conclude that urolithiasis is multifactorial, various factors may increase the risk of urinary stone formation.

Clinical and etiological profile of epilepsy at the regional hospital center of Tahoua (Niger): A 4-year retrospective study.

ObjectiveWe aimed to evaluate epilepsy management at the regional hospital center (RHC) of Tahoua (Niger) to determine the intrahospital deficiencies to optimize to improve the management of people with epilepsy.MethodsA descriptive retrospective study was carried out at the Psychiatric Unit of the RHC of Tahoua between January 1, 2016 and December 31, 2019. We collected from the registers of consultation all patients followed by nurse technicians in mental health for epilepsy whose diagnosis was made by nonspecialist physicians or internists. The study included patients with epilepsy who had a medical follow‐up at least 6 months.ResultsOf the 2022 patients seen during the period of the study, 246 patients were consulted for epilepsy with a hospital frequency of 12.2%. The mean age was 22.38 years, with a slight predominance of men (57.7%). Only generalized tonic‐clonic seizures (95.1%) and focal‐aware seizures (4.9%) were reported. The main etiologies were cerebral malaria (18.7%), bacterial meningitis (8.1%), and head trauma (4.9%). In 60.2% of cases, the etiology was undetermined, but the etiological diagnosis investigation was incomplete (CT scan not done). Only the first‐generation antiepileptic drugs were used. Only 2.8% of the patients had drug‐resistant epilepsy, and 97.2% of the patients had controlled seizures.ConclusionThe study shows a predominance of infectious causes, particularly cerebral malaria. We found a high proportion of epilepsies with unknown etiologies with incomplete workup. The RHC of Tahoua should facilitate access to the CT scan for people with epilepsy to improve etiological diagnosis investigation.

Ischemic stroke in Morocco: Prehospital delay and associated factors

ObjectivesThis study aimed to estimate prehospital delay and to identify the factors associated with the late arrival of patients with ischemic stroke at the Souss Massa Regional Hospital Center in Morocco. Patients and methodsAn observational, prospective, cross-sectional study was conducted from March 2019 to September 2019 in the Souss Massa regional hospital center, which is a public hospital structure. A questionnaire was administered to patients with ischemic stroke and to bystanders (family or others), while clinical and paraclinical data were collected from medical records. Univariate and multivariate logistic regression analyses were used to identify the factors associated with delayed arrival at emergency department. ResultsA total of 197 patients and 197 bystanders who fulfilled the criteria for the study were included. The median time from symptom onset to hospital arrival was 6hours (IQR, 4–16). Multiple regression analysis showed that illiteracy (OR 38.58; CI95%: 3.40–437.27), waiting for symptoms to disappear (patient behavior) (OR 11.24; CI95%: 1.57–80.45), deciding to go directly to the hospital (patient behavior) (OR 0.07; CI95%: 0.01–0.57), bystander's knowledge that stroke is a disease requiring urgent care within a limited therapeutic window (OR 0.005; CI95%: 0.00–0.36), and direct admission without reference (OR 0.005; CI95%: 0.00–0.07), were independently associated with late arrival (>4.5hours) of patients with acute ischemic stroke. In addition, illiteracy (OR 24.62; CI95%: 4.37–138.69), vertigo and disturbance of balance or coordination (OR 0.14; CI95%: 0.03–0.73), the relative's knowledge that stroke is a disease requiring urgent care and within a limited therapeutic window (OR 0.03; CI95%: 0.00–0.22), calling for an ambulance (relative's behavior) (OR 0.16; CI95%: 0.03–0.80), distance between 50 and 100km (OR 10.16; CI95%: 1.16–89.33), and direct admission without reference (OR 0.03; CI95%: 0.00–0.14), were independently associated with late arrival (>6hours) of patients with acute ischemic stroke. ConclusionPatient behavior, bystander knowledge and direct admission to the competent hospital for stroke care are modifiable factors potentially useful for reducing onset-to-door time, and thereby increasing the implementation rates of acute stroke therapies.

Acceptability of neonatal sickle cell disease screening among parturient women at the Paul Moukambi Regional Hospital in rural Eastern Gabon, Central Africa.

Neonatal screening and the effective management of sickle cell disease (SCD) are now well established in urban areas in some sub-Saharan African countries. The high rate of sickle cell trait in Koula-Moutou, Gabon, prompted an assessment of the psycho-clinical context of the introduction of neonatal screening in this rural area in eastern Gabon. Interviews were conducted with 215 women from February to June 2016 in Maternity and Maternal Child Protection services at the Paul Moukambi Regional Hospital Center in Koula-Moutou. Few childbearing women knew about SCD (24%), very few (6%) knew their hemoglobin status and only 30% of parturient women authorized sampling for neonatal SCD screening. Young mothers aged 16-28 years (p=0.018) and those who were educated (p=0.002) were more likely to authorize neonatal blood screening. There was no association between acceptance of blood sampling and knowledge of SCD or the parturient woman's hemoglobin status. The barriers to acceptance for SCD neonatal diagnosis are related to the education and culture rather than the knowledge of this disease. Introduction of diagnosis in rural areas requires a team comprising a psychosocial worker and health workers known to the rural population, to remove inhibitions related to blood collection from newborn infants.

Key Drivers of Internal Market Changes and Innovative Tools Towards an Efficient Business Climate

This paper has an emphasis on analytical approach to certain key factors of internal marketing. Examining the strength of their impact (financial and non-financial) on the employee motivation levels, in September 2019 the conducted survey comprised 300 respondents (sample size), employees - internal customers, nurses and hospital staff. Data were collected based on a survey of employee satisfaction, area of their jobs. Respondents were employees / hospital staff of the regional hospital center in the Republic of Croatia. Analyzed areas had been previously sequenced and grouped in accordance with key factors that corresponded to the areas of internal marketing with intensities of their impacts on the level of the satisfaction, motivation and the employee productivity. In the analysis, inferential statistics methods (Z-test, Chi-Square test) were used to answer the question of whether internal marketing instruments affect employment motivation, and to what extent is the response positive, to what extent they affect motivation, and indirectly, to work productivity. Questions related to salary, satisfaction with the basic salary, type of employment, and type of work provided answers about employee motivation with regard to the financial factor of internal marketing, and questions related to when employees use a break at work gave us the answer about the free time to which the employee is entitled to, and which affects the level of his satisfaction. The questions concentrated on work experiences of employees in the organization presented their loyalty to the non-profit organization. Main domains that represented key incentives throughout the interactive empowerments of key factors analyzed are education, participation in professional lectures and seminars, conferences, and additional training for application of innovative tools. Results confirm basic attitudes about employment in non-profit organizations, i.e. that the financial factor is not decisive in choosing employment. Results show narrow connection of loyalty with employee’s motivation as non-financial factor of internal marketing, showing in that manner the interest of employees for achievements supported by the internal confidence and permanent positive behavior or the attitude. These research results contribute to improving the elements of internal marketing. Internal customers' attitudes and behavior (i.e., their satisfaction and commitment) is affected by the organizational atmosphere component. It is closely tied to internal customers' creativity and productivity. Therefore, it is an essential element of organizational performance.

Cardiovascular manifestations of intermediate and major hyperhomocysteinemia due to vitamin B12 and folate deficiency and/or inherited disorders of one-carbon metabolism: a 3.5-year retrospective cross-sectional study of consecutive patients

The association of moderate hyperhomocysteinemia (HHcy) (15-30 μmol/L) with cardiovascular diseases (CVD) has been challenged by the lack of benefit of vitamin supplementation to lowering homocysteine. Consequently, the results of interventional studies have confused the debate regarding the management of patients with intermediate/severe HHcy. We sought to evaluate the association of intermediate (30-100 μmol/L) and severe (>100 μmol/L) HHcy related to vitamin deficiencies and/or inherited disorders with CVD outcomes. We performed a retrospective cross-sectional study on consecutive patients who underwent a homocysteine assay in a French University Regional Hospital Center. Patients with CVD outcomes were assessed for vitamin B12, folate, Hcy, methylmalonic acid, and next-generation clinical exome sequencing. We evaluated 165 patients hospitalized for thromboembolic and other cardiovascular (CV) manifestations among 1006 patients consecutively recruited. Among them, 84% (138/165) had Hcy>30 μmol/L, 27% Hcy>50 μmol/L (44/165) and 3% Hcy>100 μmol/L (5/165). HHcy was related to vitamin B12 and/or folate deficiency in 55% (87/165), mutations in one or more genes of one-carbon and/or vitamin B12 metabolisms in 11% (19/165), and severe renal failure in 15% (21/141) of the studied patients. HHcy was the single vascular risk retrieved in almost 9% (15/165) of patients. Sixty % (101/165) of patients received a supplementation to treat HHcy, with a significant decrease in median Hcy from 41 to 17 µmol/L (IQR: 33.6-60.4 compared with 12.1-28). No recurrence of thromboembolic manifestations was observed after supplementation and antithrombotic treatment of patients who had HHcy as a single risk, after ∼4 y of follow-up. The high frequency of intermediate/severe HHcy differs from the frequent moderate HHcy reported in previous observational studies of patients with pre-existing CVD. Our study points out the importance of diagnosing and treating nutritional deficiencies and inherited disorders to reverse intermediate/severe HHcy associated with CVD outcomes.

Evaluation of determinants of the use of health mutuals by the population of the Ziguinchor region in Senegal

Access to health services is a concern around the world. Different strategies were developed, but Africa’s rate remains the lowest. This article aims to contribute to the population's access to healthcare, and to assess the determinants of the use of mutual health insurance by the population of the Ziguinchor region in Senegal. Methods: The study is transversal and descriptive, carried out from July to August 2018. Through the quota method we defined the number of patients to be interviewed. Thus, by a geographic stratification according to the departments and a second-degree stratification taking into account the staff of the different hospital departments, 392 patients were selected. Results: 73% at the Regional Hospital Center and 27% at the Regional Peace Hospital. Response rate: 97%, women 60% and men 40%. The enrollment for women (24%) is slightly higher than that for men (21%). Socio-economic factors. The rate of adherence is the highest of for patients with university level, followed by high school; income: the highest rate for patients with a monthly income between 200,000 and 500,000 FCFA, followed by patients with an income monthly between 100,000 and 200,000 FCFA. Factors linked to the provision of care: the rate of Mutual Health Insurance adherence follows distances from patients' homes. Concerning the relation to satisfaction, education, distance and information are more determining than adherence rate. Recommendations: 1) State: actions on education and distance; 2) Sensitizing the population on mutual health insurance; 3) Urging healthcare providers to reduce waiting times and respect schedules as well as appointments.

Psychoeducation, Psychiatric Education and Psychoprophylaxis as an Integral Part of the Work of a Psychiatrist in an Outpatient Consultative Appointment

Introduction: hygienic education of the population includes a set of educational, upbringing, agitation and propaganda activities aimed at promoting a healthy lifestyle, preventing diseases, maintaining and strengthening health, increasing the working capacity of people, and prolonging their active life.Material and methods: the analysis of 5 qualification works of a psychiatrist was carried out for the hygienic and health education. The depth of the study was 24 years. When working on the material, the following methodological approaches were used: systemic, complex, dynamic, normative, quantitative and situational. Analysis methods included: historical, analytical and comparison. The following techniques were used for the analysis: groupings, absolute values, continuous and selective observations.Results: psychiatric reception in the advisory department of GAUZ RK “CDC RK” is carried out by one specialist. Individual psychoeducation, psychiatric education and psychoprophylaxis accompany the entire treatment process of persons with mental disorders. The psychiatrist of the regional center is constantly engaged in psychoeducation of the population, works with the medical staff of the institution and central regional hospitals, is engaged in methodological and research work. Discussion: health education in psychiatry in all forms contributes to a wider medical prevention of the development of pathology in the mental sphere, as well as to the improvement of already developing diseases and the prevention of relapse of already cured diseases. Despite the fact that the psychiatrist deals with such topics that are not of a pronounced psychological nature, they always include psychological problems, since they relate to human relationships, provide people with information, recommendations, advice and act on them emotively. Conclusions: sanitary and educational work in psychiatry is aimed at increasing the level of knowledge of the population about mental disorders, mastering methods of protection from stress, the harmful effects of bad habits. Individual health education accompanies the entire treatment process.

HUBUNGAN PENDAMPING SUAMI DENGAN KALA DUA LAMA PADA IBU BERSALIN

Old labor is one of the fourth leading causes of maternal mortality in Indonesia. The incidence of old childbirth in 2007 and 2012 is still the same, namely 5%.This study aims to study the relationship between birth companion and the incidence of prolonged second stage of labor among women in labor. This study used a survey analytical research design with a cross sectional approach. The study sample were 124 women in labor in Sakura Ward of Central Bengkulu Regional Hospital in 2019, who were taken by total sampling. Data to be analysed in this study were secondary data, that were collected using a checklist and data collection form as the study instruments. The results showed that of the 124 mothers who gave birth, 28.2% experienced prolonged second stage of labor and 71.8% did not experience it, 46.8% were not accompanied by their husbands and 53.2 were accompanied by their husbands. There was a significant relationship between the presence of a birth companion and the incidence of prolonged second stage of labor among women in labor. Women in labor who were not accompanied by their husbands were at risk of experiencing prolonged second stage of labor by 3.529 times compared to them who were accompanied by their husbands. It was concluded that there was a significant relationship between husbands companion and the incidence prolonged second stage of labor among women in labor. It is expected that this study can improve health services and appropriate screening to the incidence of prolonged second stage of labor among women in labor. Furthermore, husbands are expected to be present as the birth companion.

Treatment Problem of the Upper Aero Digestive Tract’s Cancers at the Regional Hospital Center of Ziguinchor in Southern Senegal

Treatment Problem of the Upper Aero Digestive Tract’s Cancers at the Regional Hospital Center of Ziguinchor in Southern Senegal