Introduction: This study aims to evaluate the water supply system as well as hygiene and sanitation measures in schools. Materials and methods: It was a descriptive cross-sectional study conducted in ten schools in the commune of Mangobo from October 5 to November 5, 2024. Direct observation was used to collect data based on an observation and interview grid. Entered in Excel, the data were imported into STATA 15 for statistical analyses. Results: The schools in the private and official networks were dominant. The majority had fewer than 1500 students, fewer than 20 teachers, and more than 20 classrooms. The schoolyards were enclosed with temporary materials. A large number of schools do not have puddles of water in the courtyard and are not littered with waste. However, an average level of classroom maintenance and overall sanitation was observed. All schools had a source of drinking water from the water distribution authority, available in the courtyard in 3/5 of the cases. The establishments had latrines in 3/5 of the cases, the vast majority of which were separated by category with a locking system. Disinfection materials were less available. The overall condition of the latrines was good in the vast majority of cases. Six out of ten schools had handwashing facilities, but water and soap were consistently available in three out of five cases. Conclusion: It is important to take into account the need and functioning of hygiene and sanitation facilities to ensure sanitary conditions in schools.

Background: The tetanus vaccine in pregnancy is crucial for preventing tetanus, a potentially fatal bacterial infection. Tetanus is particularly dangerous for newborns if contracted by pregnant women, as it can lead to neonatal tetanus. The vaccine, typically given as part of the Tdap (tetanus, diphtheria, and pertussis) vaccine, helps protect both the mother and the unborn child by passing on antibodies. It's generally recommended during the third trimester of each pregnancy, providing passive immunity to the newborn until they're old enough to receive their own vaccinations. The tetanus vaccine, when administered during pregnancy, has been shown to be safe for both the mother and the developing fetus. Numerous studies have demonstrated its safety profile. Timing: The vaccine is typically recommended during the third trimester of each pregnancy, ideally between weeks 27 and 36. This vaccination timing ensures optimal transplacental transfer of protective antibodies to the fetus. Tetanus, caused by the neurotoxin-producing bacterium Clostridium tetani, presents significant risk due to its ubiquitous presence in soil, dust, and animal face. Objective: This study investigates women's awareness of the tetanus vaccine and measures its association with Clinical outcomes. Methods: This is a cross-sectional study. Data were collected from thirty women who attended the Yarmouk Primary Health Care. It included the data collected by the researchers, the questions were explained face to face, samples were taken and recorded manually, and then collected via the Excel program. The data was analyzed using the Statistical Package for the Social Sciences (IBM SPSS) version20. The confidence level is 95% with a significant level of P < 0.05. Results: The sample consisted of 30 case (mean age 33.17 years; minimum 20 yr and maximum 45yr). Taking into account the educational level of each woman, it was noted that this affects prenatal health care and general information about the vaccine. 96% of women received the tetanus vaccine, of which 41% percent received the full five doses.

Papillary carcinoma of the thyroid is a follicular type cancer, constituting the dominant histological type of all malignant neoplasms affecting the thyroid gland. His prognosis is generally favorable. The situations where this cancer becomes refractory to the action of radio-metabolic therapy are a real challenge for any clinician. The surgical resumption whenever possible, the use of chemotherapy with tyrosine kinase inhibiting agents, and external radiation therapy are the pillars of management in this type of cancer. We expose through three observations this issue and we discuss the approach toward this clinical situation.

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Monkeypox otherwise known as Mpox is a zoonotic disease caused by monkeypox virus which belongs to the genus Orthopox virus of the family Poxviridae; a large and diverse family of enveloped double stranded DNA viruses that replicate in the cytoplasm of infected cells. First discovered in 1958 with confirmed case first described in 1970, Monkeypox remains a reoccurrence especially in West African countries such as Nigeria. It occurs primarily in tropical rainforest areas of central and West Africa and is occasionally exported to other regions. There are two distinct genetic clades of the monkeypox virus: the central African (Congo Basin) clade and the West African clade with the earlier historically causing more severe disease and was thought to be more transmissible. In recent times, the case fatality ratio has been around 3–6%. Mpox is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus. Clinical presentation resembles that of smallpox, a related orthopoxvirus infection which was declared eradicated worldwide in 1980. Mpox typically presents clinically with fever, rash and swollen lymph nodes and may lead to a range of medical complications. The gold standard method of diagnosis is by polymerase chain reaction (PCR) method with others including viral culture, antibody testing and electron microscopy. This review x-rays the pathogenesis, risk factors, clinical presentations, associated complications, laboratory diagnosis, prevention and management of Mpox highlighting the need for utilization of an integrated approach that include immunization, antiviral treatments, and public health policies tailored to high-risk populations in combatting the disease. The need for training and retraining of Laboratory Scientists and personnels to acquire improved diagnostic skills desired in order to effectively control and reduce the impact of Mpox is highly needed.

Introduction: Signing against medical advice (SAMA) or discharge against medical advice (DAMA) is a fairly common occurrence among patients presenting to trauma with extremity fractures. The study aims to report the reasons for SAMA among these patients. Materials and Methods: This was a retrospective study of 105 admitted patients and later SAMA at the trauma centre of the Usmanu Danfodio University Teaching Hospital (UDUTH), Sokoto, Nigeria between February 2023 and December 2024. The study criteria included all patients with extremity fractures. The reason for SAMA within or more than 24 hours of admission includes the type of fractures (closed fracture, poly-trauma, multiple fractures or open fracture), financial, preference to traditional bone setting or proximity to home. The data analysis was done using SPSS Version 23. Results: There was a total of 105 patients in the study who SAMA. The SAMA prevalence was 3.7%. There were 90 (85.7%) males and 15 (14.3%) females. The mean age of patients was 32±19.55 (range 2 to 85). The most frequent age affected was 25 (9 patients) and the most involved age group was from 20 to 40 years with 54 (51.4%) patients. Eighty-one (77.1%) patients have SAMA within the first 24 hours of admission while 24 (22.9%) SAMA after 24 hours of admission (p-value <0.0001). There were 70 (66.7%) with closed fractures, 19 (18.1%) with polytrauma, 11 (10.5%) with multiple fractures, and 5 (4.8%) with open fractures. The reasons for SAMA were due to financial factors in 66 (62.9%) patients, preference for traditional bone setting (TBS) in 28 (26.7%) patients, and due to being closer to home in 11 (10.5%) patients. Conclusion: This study shows majority of patients had SAMA within the first 24 hours and occurred commonly among younger age groups, male gender, in patients with financial issues, preference for TBS, and closed fractures.

Introduction: Scientific research in education is simply the application of the general rules of the scientific method to the field of education. This study aims to compare the qualitative performance of students at technical medical institutes in the city of Kisangani and analyse these issues to verify whether they are valid. Materials and methods: This was a descriptive cross-sectional study conducted at the Technical Medical Institute of the University of Kisangani (ITM – UNIKIS) and the Institute of Applied Medical Technology of the Higher Institute of Medical Technology of Kisangani (ITMA – ISTM/ KIS) from 1 March to 30 April 2023. A non-probabilistic convenience sample of 25 students was selected. Document analysis and questionnaires were used to collect data, while descriptive analysis was used to compare results. Results: Current course programmes, subject forecasts and course reference materials are available at ITM – UNIKIS, while at ITMA – ISTM/ KIS. At ITM – UNIKIS, all questions are valid, while at ITMA – ISTM/KIS, 50% do not comply with the curriculum and subject forecasts. The pass rate in pathology and nursing techniques was 66.3% at ITM – UNIKIS (MML=83.3% vs DDL=58.3%) and 53.5% at ITMA – ISTM/KIS (MML=52.9% vs DDL=29.4%). In nursing techniques, it was 65% at ITM UNIKIS (MML=97.6% vs DDL=50%) and 55.5% at ITMA – ISTM/KIS (MML=76.4% vs DDL=17.6%). Conclusion: The qualitative performance of learners in the competency-based programme is better than that of learners in the objective-based programme.

Background: Accurate and early detection of postoperative complications after elective liver resection (LR) remains a challenge. A reliable predictor is essential for guiding therapy and improving outcomes. This study aimed to evaluate the role of serum procalcitonin (PCT) in predicting postoperative complications after LR. Methods: This prospective observational study was conducted at BSMMU, Dhaka, from July 2021 to June 2024. A total of 84 patients undergoing elective LR were included. Informed consent was obtained before surgery. Serum PCT levels were measured on postoperative days (POD) 1, 3, and 7 using the Siemens Atellica IM BRAHMS PCT analyzer. Other markers, including WBC count, CRP, and liver and renal function tests, were also recorded. Patients were categorized into two groups: those without complications (group 1, n=20) and those with complications (group 2, n=22). Statistical analyses were conducted using SPSS 25.0, with a significance level of P<0.05. Results: Postoperative complications occurred in 52.4% of patients. Mean serum PCT levels were significantly higher in group 2 than in group 1 on POD 1 (0.898 ± 0.787 vs. 2.508 ± 2.587 µg/L, P=0.011), POD 3 (0.314 ± 0.249 vs. 0.890 ± 0.735 µg/L, P=0.002), and POD 7 (0.181 ± 0.217 vs. 0.611 ± 0.610 µg/L, P=0.005). WBC count and CRP levels did not show statistical significance. ROC analysis identified a PCT cutoff of 1.100 µg/L on POD 1, with sensitivity 86.4%, specificity 70.0%, PPV 74.2%, and NPV 83.7%. Conclusion: Serum PCT on POD 1 is a strong early predictor of complications after elective LR. A cutoff value of 1.100 µg/L accurately predicts morbidities, regardless of the type of disease or surgical procedure.

Schmidt's syndrome combines several autoimmune diseases, including Addison's disease, thyroiditis and peripheral gonadal insufficiency. A 21-year-old female presented 15 days prior to admission with a digestive complaint of nausea, vomiting, generalised asthenia and epigastric pain, all evolving in a context of weight loss. Clinical examination revealed an altered patient, hypotensive to 80/60 mmHg, normocardial to 70 bpm. Paraclinical examinations revealed acute renal failure, hyperkalaemia (8 mmol/l) and hyponatraemia (124 mmol/l). Given the hyperkalaemia without electrical signs on ECG, the patient was treated with Kayxalate and calcium gluconate and hydration with saline and sodium; the blood ionogram improved. In the face of chronic constipation, a TSH was performed, returning to 11 uui/ml with antiTPO antibodies at 1000. An ultrasound scan revealed thyroiditis, and the patient was put on levothyrox 50ug/d. The patient continued to suffer from profound asthenia and also reported secondary amenorrhoea for 4 months with negative BHCG and a hypophysiogram showing hypergonadotropic hypogonadism in favour of primary ovarian failure. On re-examining the patient, our attention was drawn to the presence of hyperpigmentation of the skin and slate- coloured patches, slate-coloured patches in the oral mucosa. The diagnosis of Addison's disease was suspected. A cortisol assay was ordered, which came back collapsed at 0.01μg/dl with ACTH elevated to 199pg/ml with anti-21-hydroxylase antibodies at 5.0U/ml (VN<0.4) confirming the diagnosis. The patient was started on intravenous hydration and hydrocortisone, with marked improvement in clinical and paraclinical parameters and restoration of menstrual cycles, followed by oral hydrocortisone and fludrocortisone. As part of the etiological diagnosis, an adrenal CT scan revealed adrenal atrophy (absence of visible adrenal parenchyma). Other autoimmune disorders in the context of polyendocrinopathy were ruled out in our patient. Adrenal insufficiency is most often caused by an autoimmune disease. Autoantibodies to steroidogenic enzymes in the adrenal cortex are present in 86% of patients with primary autoimmune adrenal insufficiency, the most common antibody being anti-21- hydroxylase.