Ubumenyi busangiwe bugira agaciro,inkuru nyinshi z'uru rubuga ziba zaraciye k'umuseke.com

Ubumenyi busangiwe bugira agaciro,inkuru nyinshi z'uru rubuga ziba zaraciye k'umuseke.com

samedi 24 mars 2012

Evidence needed before redefining severe forms of drug-resistant tuberculosis


23 March 2012 -- Reports of tuberculosis (TB) cases with severe patterns of drug resistance are increasing, said experts who attended a WHO meeting in Geneva on 21-22 March. Participants stressed that the emergence of drug resistance should be a wake-up call for Ministries of Health. Greater efforts are needed to prevent drug resistance and avoid a scenario where TB becomes incurable


please download the new policy of treatment of TB at :http://whqlibdoc.who.int/publications/2012/9789241503006_eng.pdf

source: WHO

vendredi 23 mars 2012

Agahimbazamusyi k'abaganga ntikavuyeho, haranozwa uko katangwaga -Binagwaho


Agahimbazamusyi k\
 
 
Mu kiganiro n’abanyamakuru cyabaye ejo ku wa kane tariki ya 22 Werurwe, Minisitri w’Ubuzima Dr Binagwaho yasobanuye ko  hagamijwe guca ubusumbane n’akajagari mu itangwa ry’agahimbazamusyi, hari komite y’abaganga batowe mu mavuriro yose yo mu gihugu, bafatanyije n’abaforomo ndetse n’uhagarariye za farumasi bakaba barimo kunoza gahunda nshya y’imitangire y’ako gahimbazamusyi ku buryo bungana.
Minisitri Binagwaho yongeye kuvuga ko agahimbazamusyi k’abaganga katavanyweho nk’uko byakomeje kuvugwa hirya no hino mu gihugu,  ahubwo ko hanozwa uburyo katangwa neza kandi bigatangirana n’uku kwezi. Kuri iyi ngingo avuga ko   hashyizweho komite y’abaganga barimo kwiga uburyo  ako gahimbazamusyi kagiye kujya gatangwa  bijyanye na serivisi zitangwa kwa muganga n’uburyo abaganga buzuza ibyo basabwa n’abarwayi babagana. Iyi gahunda  ya PBF n’ubwo yari isanzweho ku bakozi bakora mu buvuzi, Minisitri w’ubuzima avuga ko uburyo amafranga yatangwaga bitari bijyanye n’igihe, kuko yatangijwe mu mwaka wa 2007. Dr Binagwaho agira ati: “ Uhereye mu mwaka wa 2007 ubwo PBF yatangizwazaga hari byinshi byahindutse, umubare w’abarwayi wariyongereye kubera mituweli,  serivisi zitangirwa kwa muganga nazo  zariyongereye kimwe  n’abakozi, kuva ku  baganga abaforomo n’abandi bakora mu buvuzi”.
Gushyira amavuriro mu  byiciro nka kimwe mu bizagenderwaho
Nk’uko Minisitri Binagwaho abisobanura,  hagamijwe guca agasumbane mu itangwa  ry’agahimmazamusyi, amavuriro yo mu Rwanda hashyizwe muri zone 4 (bitewe n’aho ari n’ibibazo afite). Zone ya mbere ikaba igizwe n’amavuriro ari  ahantu habi, hatagendeka, bigoye gukorera. Iyi zone igizwe n’ ibitaro by’i Gakoma, Kaduha, Mugonero, Munini, Murunda, Ngarama, Ruli na Shyira. Zone ya kabiri yo igizwe n’ibitaro bisa nk’ibiri mu bwigunge bidakabije,   gusa  nabyo bifite ikibazo cyo kuba bitegereye neza umuhanda mwiza. Harimo  nk’ ibitaro by’i  Bushenge, Butaro, Gahini, Gitwe, Kabaya, Kibirizi, Kibogora, Kirehe, Kirinda, Kiziguro, Muhororo, Nemba, Remera-Rukoma na  Rutongo. Indi zone igizwe n’ibitaro bw’ibyahoze ari amaperefegitura. Bigizwe n’Ibitaro by’I Byumba, Gihundwe, Gisenyi, Kabgayi, Kabutare, Kibungo, Kibuye, Kigeme na Nyagatare. Ikindi cyiciro gisigaye kirimo ibitaro biri mu mijyi bigaragara  ko gutezwa imbere byakoroha, bitewe n’uko biri mu mujyi byoroshye kuhagera. Harimo ibitaro by’I Kibagabaga, Muhima, Nyamata, Nyanza, Ruhengeri, Rwamagana, na Rwinkwavu.
Nk’uko bisobanurwa na Dr Kanyankore William, umwe mu baganga bari muri komite yatowe n ngo banonosore neza ibijyanye n’agahimbazamusyi k’abakora mu buvuzi,  bitarenze mu mpera z’iki cyumweru nibwo hazatangwa ibyemejwe n’abo baganga bahagarariye zone zose twavuze haruguru. Minisitri Binagwaho avuga ko byari bimaze kugaragara ko hari amavuriro   yakiraga abarwayi benshi, abakozi bakora cyane,  nyamara ntabe ariyo abona amafranga menshi mu gahimbazamusyi. Ikindi akaba ari amavuriro yo mu cyaro atakundaga kwitabirwa n’abakozi, abenshi bifuzaga kwigira mu mujyi. Ikindi kigenderwaho mu itegurwa rishya ry’agahimbazamusyi  nk’uko bisobanurwa ni imiterere y’ivuriro, ibibazo rifite, n’aho riherereye bivuze ko nta busumbane buzongera kugaragara. Minisitri Binagwaho avuga ko muri rusange abaganga n’abandi bakora mu buvuzi bose bitanga kandi umusaruro wabo ari mwiza ariyo mpamvu hategurwa icyabazanira inyungu bose, ntawe usumbije abandi bari ku rwego rumwe. Nibura mu bitaro byose byo mu gihugu hari abaganga 7 intego akaba ri ukugeza ku baganga nibura 14 kandi akabona umushahara we neza. Kugeza ubu amafranga macye umuganga atahana iwe ubariyemo n’agahimbazamusyi n’andi mafranga ahabwa ni 350.000 ku kwezi. Minisitri w’ubuzima akaba avuga ko atari macye ugereranyije n’ubukungu bw’igihugu ndetse n’imishahara y’abandi bakozi mu Rwanda.

What should you do if someone has a heart attack?

Getty - heart attack


A heart attack will cause severe chest pains behind the breast bone, often radiating towards the left arm.

If someone has a cardiac arrest or heart attack, there may be only a few minutes to act before it is too late. It is vital to know what to do beforehand.
To perform CPR (cardiopulmonary resuscitation) and artificial respiration (mouth to mouth resuscitation) effectively, training and frequent practice on resuscitation dummies are essential.
First aid courses are offered all over the country at night schools or by voluntary organisations such as St John Ambulance or British Red Cross.

How can you tell if someone is having a heart attack?

If the person is unconscious:
  • are they breathing? Look at the patient's chest to see if it is rising and falling
  • do they have a pulse? Place two fingers on one or other side of the person's voice box in their throat to feel if they have a carotid pulse.
If the patient has a pulse but is not breathing:
  • could it be because of suffocation? Feel inside the mouth with a finger to see if there is anything blocking it or the windpipe and remove any food or other objects. Provided that dentures are not broken, it is better not to remove them
  • call for help immediately, stating that the casualty is not breathing, and provide resuscitation (see below) until the patient begins to breathe or the ambulance arrives.
If there is no breathing or pulse, the patient has had a cardiac arrest.

What help is needed?

  • Immediately place the palm of your hand flat on the patient's chest just over the lower part of the sternum (breast bone) and press your hand in a pumping motion once or twice by using the other hand. This may make the heart beat again.
If these actions do not restore a pulse or if the subject doesn't begin to breathe again:
  • call for help, stating that the casualty is having a cardiac arrest but stay with the patient
  • find out if any one else present knows CPR
  • provide artificial respiration immediately (see below)
  • begin CPR immediately (see below).

How do I perform CPR (cardiopulmonary resuscitation)?

See if there is breathing. If not, start artificial respiration as described above. Checking for a pulse in the neck (carotid artery) may waste valuable time if the rescuer is inexperienced in this check. The procedure is:
  • place your fingers in the groove between the windpipe and the muscles of the side of the neck. Press backwards here to check for a pulse.
If there is no pulse, or if you are unsure, then proceed without delay thus:
  • look at the person's chest and find the 'upside-down V' shaped notch that is made by the lower edge of the ribcage. Place your middle finger in this notch and then place your index finger beside it, resting on the breastbone. Take the heel of your other hand and slide it down the breastbone until it is touching this index finger. The heel of your hand should now be positioned on the middle of the lower half of the breastbone.
  • now place the heel of your other hand on top of the first. Keep your fingers off the chest, by locking them together. Your pressure should be applied through the heels of the hands only.
  • keep your elbows straight, and bring your body weight over your hands to make it easier to press down.
  • press down firmly and quickly to achieve a downwards movement of 4 to 5cm, then relax and repeat the compression.
  • do this 15 times, then give artificial respiration twice, and continue this 15:2 procedure until help arrives.
  • aim for a rate of compression of about 100 per minute. You can help your timing and counting by saying out loud 'one and two and three and four ...' etc.

How to give artificial respiration

  • Tilt the head back and lift up the chin.
  • Pinch the nostrils shut with two fingers to prevent leakage of air.
  • Take a deep breath and seal your own mouth over the person's mouth.
  • Breathe slowly into the person's mouth - it should take about two seconds to adequately inflate the chest.
  • Do this twice.
  • Check to see if the chest rises as you breathe into the patient.
  • If it does, enough air is being blown in.
  • If there is resistance, try to hold the head back further and lift the chin again.
  • Repeat this procedure until help arrives or the person starts breathing again.

Artificial respiration and CPR should both be performed at the same time

  • If possible, get someone else to help - one person to perform artificial respiration and the other to perform CPR. (This is not easily done without prior practice and it is well worth attending sessions on CPR training to become familiar with the technique.)
  • The ratio of chest compressions to breaths is 30:2 for both one-person and two-person CPR.
  • Continue until the ambulance arrives or the patient gets a pulse and starts to breathe again.
  • If the pulse returns and breathing begins but the person remains unconscious, roll them gently onto their side into the recovery position. This way mucus or vomit can get out of the mouth and will not obstruct the patient's breathing. It also prevents the tongue from falling back and blocking the air passage.

Make sure the patient continues breathing and has a pulse until the ambulance arrives

  • If you succeed in resuscitating the person who has been taken ill, he or she may be confused and alarmed by all the commotion. Keep the patient warm and calm by quietly, but clearly, telling them what has happened.
Again, it needs to be emphasised that the only way to provide proper first aid and resuscitation is through learning the technique, then regular practice and guidance

asthma in children

asthma is the leading cause of chronic illness in children. It affects as many as 10%-12% of children in the U.S. and, for unknown reasons, is steadily increasing. It can begin at any age, but most children have their first symptoms by age 5.
Doctor to Patient

Asthma Risk - Who & Why?

Get statistics on young children with asthma.One of the more frequent questions my patients ask me concerns the relative risk of their child developing allergies or asthma. In previous Doctors' Views, I have raised issues relating the environment to the development of allergies or asthma. However, both a genetic predisposition and environmental/lifestyle factors are necessary for these conditions to develop.
The incidence of asthma has risen dramatically in the past 20 years—a period too short to reflect any significant changes in the gene pool. This supports the important role that environmental influences (allergy, infection, lifestyle, and diet) have on the development of asthma.
What role then does genetics (heredity) play in asthma? A genetic link in asthma has long been suspected primarily due to "clustering" of cases within families and in identical twins. This does not prove a genetic cause, since it may also reflect shared environmental exposures. Several studies conclude that heredity increases your chances of developing asthma, particularly if allergies or other allergic conditions are present. Moreover, you may pass this tendency to asthma to the next generation. So, what are the chances that your child will develop asthma?
 

What makes a child more likely to develop asthma?

There are many risk factors for developing childhood asthma. These include:
  • Presence of allergies


  • Family history of asthma and/or allergies


  • Frequent respiratory infections


  • Low birth weight


  • Exposure to tobacco smoke before and/or after birth


  • Being male


  • Being black


  • Being raised in a low-income environment

Why are more children getting asthma?

No one really knows why more and more children are developing asthma. Some experts suggest that children are being exposed to more and more allergens such as dust, air pollution, and second-hand smoke. These factors all are triggers of asthma. Others suspect that children are not exposed to enough childhood illnesses to build up their immune system. It appears that a disorder of the immune system where the body fails to make enough protective antibodies may play a role in causing asthma.
And still others suggest that decreasing rates of breastfeeding have prevented important substances of the immune system from being passed on to babies.

How can I tell if my child has asthma?

Signs and symptoms to look for include:
  • Frequent coughing spells, which may occur during play, at night, or while laughing. It is important to know that cough may be the only symptom present.


  • Less energy during play


  • Rapid breathing


  • Complaint of chest tightness or chest "hurting"


  • Whistling sound (wheezing) when breathing in or out


  • See-saw motions (retractions) in the chest from labored breathing


  • Shortness of breath, loss of breath


  • Tightened neck and chest muscles


  • Feelings of weakness or tiredness


  • Dark circles under the eyes


  • Frequent headaches


  • Loss of appetite
Keep in mind that not all children have the same asthma symptoms, and these symptoms can vary from asthma episode to the next episode in the same child. Also note that not all wheezing or coughing is caused by asthma.
In kids under 5 years of age, the most common cause of asthma-like symptoms is upper respiratory viral infections such as the common cold.
If your child has problem breathing, take him or her to the doctor immediately for an evaluation.


jeudi 15 mars 2012

Syphilis
















Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis. Other human diseases caused by related Treponema pallidum include yaws (subspecies pertenue), pinta (subspecies carateum) and bejel (subspecies endemicum).

Primary

Primary chancre of syphilis on the hand
Primary syphilis is typically acquired by direct sexual contact with the infectious lesions of another person

Secondary

Typical presentation of secondary syphilis with a rash on the palms of the hands
Reddish papules and nodules over much of the body due to secondary syphilis
Secondary syphilis occurs approximately four to ten weeks after the primary infection

Latent

Latent syphilis is defined as having serologic proof of infection without symptoms of disease

Tertiary

Tertiary syphilis may occur approximately three to 15 years after the initial infection, and may be divided into three different forms: gummatous syphilis (15%), late neurosyphilis (6.5%), and cardiovascular syphilis (10%)

Congenital

Congenital syphilis may occur during pregnancy or during birth. Two-thirds of syphilitic infants are born without symptoms. Common symptoms that then develop over the first couple years of life include: hepatosplenomegaly (70%), rash (70%), fever (40%), neurosyphylis (20%), and pneumonitis (20%). If untreated, late congenital syphilis may occur in 40%, including: saddle nose deformation, Higoumenakis sign, saber shin, or Clutton's joints among others



dimanche 4 mars 2012

know the epidemics of cholera

Cholera

Disease or epidemic cholera  is an infectious disease in the digestive tract caused by the bacterium Vibrio cholerae. These bacteria usually enters the body through drinking water contaminated by improper sanitation or by eating fish is not cooked properly, especially shellfish. Symptoms include diarrhea, abdominal cramps, nausea, vomiting, and dehydration. Death is usually caused by dehydration. If left untreated, then the patient is high risk of death. Treatment can be done with aggressive rehydration "regimen", usually delivered intravenously on an ongoing basis until the diarrhea stops.
Treatment

Rehydration

The main treatment done by restoring the lost body fluids or adequate rehydration until the disease is complete (usually 1 to 5 days without antibiotic treatment). Rehydration can be done to intravenous infusion fluids (in severe cases) or with oral rehydration with ORS (oral rehydration solution).
 


Antibiotics

Antibiotics have a secondary but important role by reducing the degree of illness and duration of excretion of the disease. Giving antibiotics should be done after vomiting symptoms subside (or after the first rehydration and recovery from acidosis). The first choice of antibiotics used in Indonesia is tetracycline and second choice is trimethoprim / sulfamethoxazole (when V. cholerae in patients resistant to tetracycline). 
 
corneille killy
 

Medics reminded to uphold ethics

Medics reminded to uphold ethics


photo
CHUK Director Dr Theobald Hategekimana (L) with Paster Ezekiel Motsoeneng distributing gifts to patients in the hospital wards yesterday. photo: The New Times 

CARE:Rights to receive good medical treatment

Medical practitioners were yesterday urged to uphold ethics and treat patients with empathy and humility.

The call was made during national commemorations to mark the 51st anniversary to recognise patients who live with chronic diseases.

During the anniversary, Dr Jean de Dieu Ngirabega, the Director General of Clinical services at the Ministry of Health said that such patients need special attention since their diseases are incurable.

“It’s important to respect the patients’ rights by offering the right care and treatments without making them feel stigmatised,” he said.

Ngirabega explained that it is a good way of enabling patients to understand that someone cares about them.

“More to that, it increases hope for the patient to recover and that is our main goal as medical practitioners,” he said.

Ngirabega also cautioned that as much as the patients have their rights to receive good medical treatment, it is also their obligation to follow the doctor’s prescription and guidelines.

On his part, Dr Theobard Hategekimana, the Director at the Central University Teaching Hospital of Kigali (CHUK) revealed that the major acute infections at the hospital include HIV/Aids, Cancer and Diabetes.

“Through counselling and providing moral support, we try as much as possible to help our patients not to lead hopeless lives,” he said.

One of the patients identified as Patrick Ntakavuro observed that service delivery at the hospital has gradually improved.

“From my experience here, there is a reasonable change in the manner in which medics handle patients’ needs,” he confessed.

Ntakavuro has been confined in hospital for almost two months nursing a broken leg he injured in a motorcycle accident.

source:TNT