RESUMO
Lightning strikes are infrequent but possibly deadly incidents. Their consequences on the human body vary and are still little known. Cardiac arrest is the main cause of death. Neurological and psychological sequelae should systematically be looked for. The most frequently reported signs are Lichtenberg figures and keronauparalysis. Care of a victim of a strike mainly depends on first aid. We found only case reports in the literature. We report here another case and discuss it including a literature review.
RESUMO
Eighty-five percent of burns occur in low- and middle-income countries, but reports on the cost of burn treatment in these countries are still rare. It is important for patients, their families, the government, society and insurance companies to be aware of the costs of burn treatment. Burn care in specialized burn units requires trained doctors and staff, specialist equipment, facilities, special tissue banks and specific dressings, and is thus very expensive. Burn care in Morocco is not as expensive as in other countries but nonetheless proves to be a high financial burden for patients, their families and the wider society. In this report we comprehensively calculate almost all the direct costs of managing in-hospital acute burns. The mean burn cost per patient in our country is US$ 16 975. We also compare the results of treatment with other reports. In this way, governmental and burn hospital authorities can have a better estimation of the direct costs of a burn center and the total budget that may be required for the whole country to cover the annual costs of treating burn patients.
Alors que 95% des brûlures surviennent dans les pays à IDH bas ou moyen, les données concernant le coût de leur prise en charge restent rares. Il est important pour les patients, leurs familles, les gouvernements et les sociétés d'assurance de connaître ce paramètre. Les soins aux brûlés dans les unités spécialisées nécessitent du personnel médical et non médical qualifié, des infrastructures, des équipements et du matériel spécifiques, une banque de peau, investissements très lourds. Bien que moins chère que dans d'autres pays, la prise en charge des brûlés au Maroc représente une charge financière importante pour les patients, leur famille, la société entière. Nous avons calculé la quasi- totalité des coûts directs d'une hospitalisation en service de soins intensifs aux brûlés, qui est en moyenne de 16 975$ et l'avons comparé aux données de la littérature. Ceci permet au gouvernement et aux directeurs d'hôpitaux de modéliser le budget nécessaire au fonctionnement d'un centre de traitement des brûlés, afin de l'abonder et de prévoir l'enveloppe nécessaire à la prise en charge des brûlés à l'échelle du pays.
RESUMO
COVID-19 pandemic is an obstacle for all health systems, especially in African countries. This paper shows how plastic surgery teams can adapt human resources and an efficient approach to provide the best care to our patients in this troubled time.
Assuntos
COVID-19 , Infecção Hospitalar , Controle de Infecções , Administração dos Cuidados ao Paciente , Centro Cirúrgico Hospitalar/organização & administração , Cirurgia Plástica , COVID-19/epidemiologia , COVID-19/prevenção & controle , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/virologia , Eficiência Organizacional , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Marrocos/epidemiologia , Inovação Organizacional , Administração dos Cuidados ao Paciente/organização & administração , Administração dos Cuidados ao Paciente/tendências , Procedimentos de Cirurgia Plástica/métodos , SARS-CoV-2 , Cirurgia Plástica/organização & administração , Cirurgia Plástica/tendênciasRESUMO
Depression as such causes emotional and physical disturbances that affect biological functions such as sleep, appetite, decreased libido and lack of interest in sexual function. Indeed, there is a significant incidence of sexual dysfunction in depressed patients. In addition, depression and sexual dysfunction have a significant impact on the quality of life of couples which can be improved by managing these two conditions between which there seems to be a two-way causal link. Sexual dysfunction has long been neglected in the clinic of depression. In Morocco, depression affects more than a quarter of the population. However, to date, no study has focused on the assessment of sexual function in relation to depression among Moroccans. OBJECTIVES: This work aimed to evaluate the prevalence and characteristics of sexual dysfunction in Moroccan patients consulting for a first depressive episode. METHODS: This is a descriptive cross-sectional study. All subjects included in this study were consulting for a first major depressive episode according to DSM-5 criteria from June 1st to November 30th, 2017 at the psychiatric university department at Ibn Nafis hospital in Marrakech. The severity of depression was assessed using the Hamilton scale. The ASEX (Arizona Sexuel Experience) scale was used to define sexual dysfunction. Statistical analysis was performed using SPSS 22 software. RESULTS: Fifty eight patients were recruited 34 of whom were female. They had an average age of 37 years. The majority were between 27 and 42 years old (59 %), married (81 %), with an average level of education (34.5 %). The average duration of the episode was 57 days. The major depressive episode was severe in 62 % of patients. According to the ASEX, 77.6 % of the depressed patients had a clinically significant sexual dysfunction. The majority of our patients (60.3 %) consulting for depression attach their sexual dysfunction to their depressed mood, either by reporting the onset of sexual dysfunction at the same time as depression (53.4 %), or worsening after the depression onset (6.9 %). The frequency of sexual intercourse with the pre-depressive state was decreased in the majority of our sample. Sexual desire was the most impaired phase of the sexual response (58.6 %) followed by excitation (53.4 %) and then orgasm (51.7 %). Of the 47 married patients, more than two thirds (32 patients) were dissatisfied with their life as a couple as well as with different aspects of their relationship life. The majority of patients reporting marital dissatisfaction attributed the cause to the quality of their sexual intercourses rather than to their frequency or other relational aspects. Sexual dysfunction was significantly correlated with the severity of depression (P=0.031), whereas it was not correlated with duration of depressive episode (P=0.412) or age or patient sex (P=0.114, P=0.202 respectively). CONCLUSIONS: The prevalence of sexual dysfunction is high in depressed patients. It significantly impacts the couple's quality of life. Although our main limitation was the small sample size which prevented us from doing a multi-varied analysis, the robust nature of this study lies in documenting the initial prevalence and types of sexual dysfunctions in both sexes in the first major depressive episode unrelated to the dysfunctions induced by antidepressant drugs. The early identification of sexual disorders and the consideration of couple dynamics would be two important elements in the management of the depressed patient.