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Post-Stroke Depression at Teaching Hospital Center of Libreville  [PDF]
I. A. Camara, C. M. Coulibaly, N. Diouf Mbourou, P. M. Gnigone, G. A. G. Mambila Matsalou, A. Nsounda Mandzela, L. Oura, J. Nyangui Mapaga, U. D. Kombila, M. M. Moubecka, P. N. Kouna
Open Access Library Journal (OALib Journal) , 2018, DOI: 10.4236/oalib.1105049
Abstract:
Introduction: Post-stroke depression occurs in a context of stroke characterized by sadness, loss of interest, feelings of guilt, loss of appetite, a feeling of tiredness, and a lack of concentration. Material and Methods: We conducted a descriptive cross-sectional study from January 1, 2013 to September 30, 2016. For the diagnosis of post-stroke depression, neuropsychological tests (DSM-IV and MADRS) were used. The collection approach was a maintenance survey followed by an examination. Results: From 153 stroke patients, 48.4% (n = 74) had post-stroke depression. Depressed mood was noted in 50.3% and 43.8% had a marked decrease in interest. 67.9% of these patients had a primary level of education. Widows had 4.2 times the risk of post-stroke depression, and married and retired patients were 3 times more likely than public servants. The occurrence of post-stroke depression was significantly related to the presence of motor deficit in our patients, p < 0.0001. Conclusion: These results suggest that the risk of developing depression after stroke increases with the motor deficit. The DSM-IV and MADRS scores remain neuropsychological examinations of choice for the diagnostic approach.
Unsteady Incompressible Flow of a Generalised Oldroyed-B Fluid between Two Infinite Parallel Plates  [PDF]
D. Bose, U. Basu
World Journal of Mechanics (WJM) , 2013, DOI: 10.4236/wjm.2013.32012
Abstract:

This paper presents a study of visco-elastic flow of an incompressible generalized Oldroyd-B fluid between two infinite parallel plates in which the constitutive equation involves fractional order time derivative. The solutions of field equations are being obtained for the motion of the said fluid between two parallel plates where the lower plate starts to move with steady velocity and the upper plate remains fixed in the first problem and the upper plate oscillates with constant frequency and the other being at rest in the second problem. The exact solutions for the velocity field are obtained by using the Laplace transform and finite Fourier Sine transform technique in terms of Mittag Leffler and generalised functions. The analytical expression for the velocity fields are derived and the effect of fractional parameters upon the velocity field is depicted graphically.

Malaria transmission in Libreville: results of a one year survey
Jean-Romain Mourou, Thierry Coffinet, Fanny Jarjaval, Christelle Cotteaux, Eve Pradines, Lydie Godefroy, Maryvonne Kombila, Frédéric Pagès
Malaria Journal , 2012, DOI: 10.1186/1475-2875-11-40
Abstract: Mosquitoes were sampled by human landing collection during 1 year in five districts of Libreville: Alibandeng, Beauséjour, Camp des Boys and Sotega. Mosquitoes were identified morphologically and by molecular methods. The Plasmodium falciparum circumsporozo?te indices were measured by ELISA, and the entomological inoculation rates (EIR) were calculated for all areas. Molecular assessments of pyrethroid knock down resistance (kdr) and of insensitive acetylcholinesterase resistance were conducted.A total of 57,531 mosquitoes were caught during 341 person-nights (161 person-nights indoor and 180 person-nights outdoor) among which, 4,223 were Anopheles gambiae s.l. The average Human Biting Rate fell from 15.5 bites per person during the rainy season to 4.7 during the dry season. The An. gambiae complex population was composed of An. gambiae s.s molecular form S (99.5%), Anopheles melas (0.3%) and An. gambiae s.s. form M (0.2%). Thirty-three out of 4,223 An. gambiae s.l. were found to be infected by P. falciparum (CSP index = 0.78%). The annual EIR was estimated at 33.9 infected bites per person per year ranging from 13 in Alibandeng to 88 in Sotega. No insensitive AChE mutation was identified but both kdr-w and kdr-e mutations were present in An. gambiae molecular form S with a higher frequency of the kdr-w allele (76%) than the kdr-e allele (23.5%).Malaria transmission in Libreville occurred mainly during the rainy season but also during the dry season in the five districts. Transmission level is high and seems to be very heterogeneous in the town. Interestingly, the highest EIR was recorded in the most central and urbanized quarter and the lowest in a peripheral area. The decrease of transmission usually seen from peri-urban areas to urban centers is probably more dependent of the socio-economic level of a quarter than of its location in the city. Urban malaria control programmes need to consider the socio economic level of an area rather than the location in the city
Malaria transmission and insecticide resistance of Anopheles gambiae in Libreville and Port-Gentil, Gabon
Jean-Romain Mourou, Thierry Coffinet, Fanny Jarjaval, Bruno Pradines, Rémi Amalvict, Christophe Rogier, Maryvonne Kombila, Frédéric Pagès
Malaria Journal , 2010, DOI: 10.1186/1475-2875-9-321
Abstract: Mosquitoes sampled by human landing collection were identified morphologically and by molecular methods. The Plasmodium falciparum circumsporozo?te (CSP) indexes were measured by ELISA, and the entomological inoculation rates (EIR) were calculated for both areas. Molecular assessments of pyrethroid knock down (kdr) resistance and of insensitive acetylcholinesterase resistance were conducted.In Libreville, Anopheles gambiae s.s. S form was the only specie of the An. gambiae complex present and was responsible of 9.4 bites per person per night. The circumsporozo?te index was 0.15% and the entomological inoculation rate estimated to be 1.23 infective bites during the four months period. In Port-Gentil, Anopheles melas (75.5% of catches) and An. gambiae s.s. S form (24.5%) were responsible of 58.7 bites per person per night. The CSP indexes were of 1.67% for An. gambiae s.s and 0.28% for An. melas and the EIRs were respectively of 1.8 infective bites per week and of 0.8 infective bites per week. Both kdr-w and kdr-e mutations in An. gambiae S form were found in Libreville and in Port-Gentil. Insensitive acetylcholinesterase has been detected for the first time in Gabon in Libreville.Malaria transmission exists in both town, but with high difference in the level of risk. The co-occurrence of molecular resistances to the main families of insecticide has implications for the effectiveness of the current vector control programmes that are based on pyrethroid-impregnated bed nets.Malaria remains a major endemic disease in tropical areas and a significant health threat to travellers and military personnel [1]. Since 2003, French forces have implemented many studies to assess the malaria risk according to the locations of troops and the insecticide susceptibility of vectors in the field [2-4]. In Gabon, malaria is predominantly caused by P. falciparum and malaria transmission is perennial and was considered until today as hyperendemic [5]. Throughout the country, infections wi
A thirteen-year analysis of Plasmodium falciparum populations reveals high conservation of the mutant pfcrt haplotype despite the withdrawal of chloroquine from national treatment guidelines in Gabon
Matthias Frank, Nicola Lehners, Pembe I Mayengue, Julian Gabor, Matthias Dal-Bianco, David U Kombila, Ghyslain Ngoma, Christian Supan, Bertrand Lell, Francine Ntoumi, Martin P Grobusch, Klaus Dietz, Peter G Kremsner
Malaria Journal , 2011, DOI: 10.1186/1475-2875-10-304
Abstract: The prevalence of the wild type pfcrt allele was assessed in 144 isolates from the years 2005 - 07 by PCR fragment restriction digest and direct sequencing. For haplotype analysis of the chromosomal regions flanking the pfcrt locus, microsatellite analysis was done on a total of 145 isolates obtained in 1995/96 (43 isolates), 2002 (47 isolates) and 2005 - 07 (55 isolates).The prevalence of the mutant pfcrt allele decreased from 100% in the years 1995/96 and 2002 to 97% in 2005 - 07. Haplotype analysis showed that in 1995/96 79% of the isolates carried the same microsatellite alleles in a chromosomal fragment spanning 39 kb surrounding the pfcrt locus. In 2002 and 2005 - 07 the prevalence of this haplotype was 62% and 58%, respectively. Pfcrt haplotype analysis showed that all wild type alleles were CVMNK.Four years after the withdrawal of CQ from national treatment guidelines the prevalence of the mutant pfcrt allele remains at 97%. The data suggest that the combination of artesunate plus AQ may result in continued selection for the mutant pfcrt haplotype even after discontinuance of CQ usage.The evolution of CQR has been a major obstacle to global public health [1]. CQR reached Africa in the late seventies and reached a high prevalence across the continent over the following decade [2]. Malawi was the first African country to discontinue the use of CQ in 1993 [3]. Interestingly, the prevalence of the resistant pfcrt allele 76T decreased drastically from 85% to 13% within the following eight years [3,4]. In 2005, a clinical trial showed a 100% efficacy of CQ for treatment of uncomplicated Plasmodium falciparum malaria in children [5]. Recently, Kenya and Tanzania have also reported a decline in CQR after replacement of CQ by sulphadoxine-pyrimethamine (SP), however, this decline occurred at a much slower rate than in Malawi [6,7].The genetic cause of CQR was found to be a single point mutation changing the amino acid lysine (K) to threonine (T) at position 76 in the
Analysis of malaria diagnosis discrepancies between RDTs and microscopy by nested PCR  [PDF]
Denise Patricia Mawili-Mboumba, Marielle Karine Bouyou-Akotet, Christelle Offouga Mbouoronde, Maryvonne Kombila
Journal of Biomedical Science and Engineering (JBiSE) , 2013, DOI: 10.4236/jbise.2013.610120
Abstract: A total of 415 samples from febrile children exhibiting either concordant (n = 108) or discordant (n = 307) results between microscopy, the gold standard diagnostic test, and two Rapid Diagnostic Tests (RDTs), OptiMAL-IT?(pLDH) and Acon?HRP2, were analysed using polymerase chain reaction (PCR) from May to December 2011 in Gabon. The aim of the study was to analyse these discrepancies using poly-merase chain reaction (PCR). Nested PCR targeting the Plasmodium ssrRNA gene was used to distinguish P. falciparum, P. malariae and P. ovale. Plasmodium falciparum was the only malaria species identified. Discrepancies frequently involved samples that were negative by microscopy and positive by Acon?HRP2 (90%) or Optimal-it?(86%). The PCR assay detected submicroscopic infection in almost 23% of the microscopy-negative samples, whereas plasmodial DNA was not found in 77% of the Acon?HRP2 positive-microscopy negative samples. Although results obtained with Optimal-it? were more frequently concordant with those of PCR genotyping, the low specificity of Optimal-iT?for non-falciparum malaria parasite detection resulted in a high proportion of false negative RDTs (90%) and a high frequency of tests with faint line intensity. The present study highlights the specific attributes of the different methods used to identify malaria parasite below the microscopy level of detection. RDT results that were discordant with either microscopy or PCR as the gold standard could represent a challenge for rapid, accurate fever case management in malaria endemic areas. It is necessary to pursue the
Complications of Pregnancy in Patients with Systemic Lupus Erythematosus (Gabon)  [PDF]
Sosthène Mayi-Tsonga, Landry Missounga, Josaphat Ibaba, Jean Ronald Edoa, Jean Baptiste Moussavou Kombila
Open Journal of Obstetrics and Gynecology (OJOG) , 2015, DOI: 10.4236/ojog.2015.58064
Abstract: Pregnancy and systemic lupus erythematosus in black African women: about 10 cases in Libreville (Gabon). Objectives: Through a study in a population of systemic lupus erythematosus (SLE) pregnant black Gabonese women, we describe the characteristics of these pregnancies to clarify their main complications and to make recommendations to their follow-up in low resource countries. Patients and Methods: This is a longitudinal descriptive study conducted over a period of six years, from 1 January 2008 to October 31, 2013, in Libreville (Gabon). We’ve included, systemic lupus erythematosus women carrying a pregnancy during the period of the study. Results: Seventy-two SLE women were followed and were eligible. Only 8 patients (11%) were pregnant during the follow up period. These 8 SLE patients allowed us to monitor 10 pregnancies. The average parity was 0.88. Eight pregnancies in ten (80%) had complications and most frequent was preeclampsia. Nine pregnancies (90%) resulted in the birth of viable children of which 4 (44.4%) were born by caesarean section and the 5 others (55.6%) were born by natural route. Conclusion: We recommend a monthly prenatal care for these high-risk pregnancies and early detection of preeclampsia.
Environmental and Occupational Risk Factors Effect to Arterial Hypertension: Correlation between Arterial Hypertension and Lead  [PDF]
D. Оyunbileg, I. Bolormаа, U. Tsolmon, О. Chimedsuren
Journal of Geoscience and Environment Protection (GEP) , 2015, DOI: 10.4236/gep.2015.32010
Abstract:

The main risk factors for hypertension include smoking, the consumption of alcohol, poor dietary habits, lack of exercise, and stress. Scientists have also linked exposure to lead as a risk factor for hypertension. Chemicals are fundamental negative factors for occupational health as they penetrate an organism through the respiratory tract in the state of vapors, gases, dust, and others. There is high correlation between the concentration of chemicals in the environment and time spent of exposure to the chemicals. Some chemicals compounds penetrate through the respiratory tract and irritate the upper respiratory track and lung lobes. They have different influences depending on their solubility. Lead has a harmful effect on organism when it is in higher doses than normal. It exerts an especially harmful effect upon the nervous and circulatory systems. Sources of environmental lead pollution are benzene, coal, paints containing lead, and some working conditions. A population based case controlling model of an analytic study was used. For the study data analysis SPSS 20.0 program were applied single and combined risk factors were accounted by regressive investigation method and results gained were expressed by odds ratio and 95% confidence interval (95% CI) p value. The goal is to assess the correlation of lead to arterial hypertension among miners of the Gobi region provinces. In the sampling we employed a random collection method with collection ratio of 1:2. One hundred miners with hypertension took part in the study. In the control group people without hypertension were assigned and they were of the same age and sex with the experimental group. Among the participants, those of working age had a high prevalence of hypertension and the disease is beginning to affect those of a younger age as well. 82% of those in the experimental group work in hard working conditions and 86% of them work for an average of 11.3 hours in noisy and dusty conditions. The increase of blood-lead content greatly depends on service length. Miners with arterial hypertension who worked for many years had a high content of lead in their blood. Lead content in the air outside of working places has a weak correlation (r = 0.3) with hypertension among those in the experimental group and was statistically significant (p = 0.007). With an increased blood-lead content, a risk for arterial hypertension (AH) increased two times (OR = 2.11 [95% CL; 1.52 - 2.94], p = 0.0001). But lead content in drinking water has an inversely associated with

Socio-economic status is inversely related to bed net use in Gabon
Julia N Goesch, Norbert G Schwarz, Marie-Luise Decker, Sunny Oyakhirome, Lea B Borchert, Ulrich D Kombila, Marc Poetschke, Bertrand Lell, Saadou Issifou, Peter G Kremsner, Martin P Grobusch
Malaria Journal , 2008, DOI: 10.1186/1475-2875-7-60
Abstract: A cross-sectional study was conducted completing pre-tested, interviewer-administered questionnaires exploring socioeconomic proxy measures with 397 mothers or guardians of young children. Respondents were grouped according to their socio-economic situation, using scores. The condition of the bed nets was evaluated during a home visit.Socio-economic factors of wellbeing were negatively associated with bed net use, such as living in a stone house (OR 0.26, 95% CI 0.14–0.48), running water in the house (OR 0.44, 95% CI 0.21–0.92), shower/flush toilet in the house (OR 0.39/0.34, 95% CI 0.21–0.75/0.16–0.73), ownership of a freezer (OR 0.50, 95% CI 0.26–0.96) and belonging to the highest group in the economic score (OR 0.32, 95% CI 0.15–0.67). In contrast, similar factors were positively associated with a good maintenance condition of the bed nets: higher monthly income (OR 5.64, 95% CI 2.41–13.19) and belonging to the highest group in the economic score (OR 2.55, 95% CI 1.19 – 5.45).Among the poorest families in Lambaréné the coverage with untreated nets (UTNs) is the highest, but the condition of these UTNs is the worst. To achieve a broad implementation of ITNs in Lambaréné, there is an urgent need for educational programmes as well as need-tailored marketing strategies for ITNs.Plasmodium falciparum malaria causes between 350 and 500 million clinical episodes and over one million deaths annually [1]. Children and pregnant women are the most vulnerable group and most endangered by the disease [2]. Insecticide-treated bed nets (ITNs) have proven to be effective [3] and also cost-effective [4,5] preventive measures against P. falciparum infection, yet their implementation in sub-Saharan Africa is still low [6-9]. New options, which could supersede the necessity of regular re-impregnation in the future, are the development of long-lasting impregnated bed nets (LLINS) [10-12] and long-lasting impregnation tablets, which provide insecticidal activity even after 30 washing
Medicina regenerativa en Andrología: Ingeniería Tisular y terapia génica como posibles opciones de tratamiento para las deformaciones peneanas y la disfunción eréctil
Schultheiss,D.; Jonas,U.;
Actas Urológicas Espa?olas , 2006, DOI: 10.4321/S0210-48062006000800008
Abstract: tissue engineering and gene therapy are currently investigated in animal studies for reconstructing penile tissue or treating erectile dysfunction. this review aims to ecamine these experimental efforts from the last years and tries to give a brief introduction to the basic methodology of these new techniques from the field of regenerative medicine.
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