Open Access Minireview Article
The baby blues is a precocious psychic impairment that may occur within the first two weeks following delivery. It is considered a trigger point, and sometimes a decompensation towards more serious postpartum psychiatric disorders. It is as well a hazard, predisposing to abnormal psycho-affective development in infants, otherwise intimately dependent on maternal bonding. Although there have been advances in understanding the psychopathology, the clinical presentations, and the inter-relationship of the condition with other disorders of perinatality, the management however remains unclear and poorly described. There seems to be confusion between indications for mere observation with monitoring on one hand, and the need for psychotherapy or pharmacotherapy on the other hand. This is maintained by the ambiguous distinction between primary baby blues which is milder, and severe baby blues with immediate and late complications that are sometimes neglected. Whereas, intervention may be necessary in a number of cases to prevent adverse outcomes in affected mothers and their infants. In this short paper, we review the management of baby blues according to the severity and we give clues for prevention, based on known protective factors.
Open Access Original Research Article
Aims: Bacterial meningitis remains a public health problem due to an unfavorable geographical environment and socioeconomic context. Our study aimed to evaluate the epidemiological-clinical, therapeutic and evolutionary profile of children treated for bacterial meningitis in the pediatric department of CHU-MEL in Benin.
Methodology: The methodology consisted in carrying out a retrospective and descriptive study of children admitted to the pediatric department of the CHU-MEL in Cotonou from January 2019 to December 2020. All children admitted in the study period were taken in consideration. Data collection (epidemiological, clinical, paraclinical, therapeutic and evolutionary) was made from registers and files and by telephone call.
Results: Our data reveal that 68 children were treated for bacterial meningitis between January 2019 to December 2020. It was also noted that the most represented age group was between 3 months and 3 years with a rate of 52.9%. Most (95.6%) of the children had no particular history. The antibiotics used were ampicillin (17.4%), ceftriaxone (52.2%), cefotaxime (4.3%) and ciprofloxacin (8.7%). For the exploration of cases of meningitis, apart from the cytobacteriological examination of the cerebrospinal fluid (CSF), the blood culture, the complete blood count (NFS) and the C-reactive protein (CRP) were the examinations commonly requested.
Conclusion: It is observed that children treated as meningitis have varying clinical signs. Meningitis cases have different ends. In case of bacterial meningitis, it is important to determine the germs to ensure proper antibiotic therapy to be conducted.
Open Access Original Research Article
Objectives: The aim of this work was to study the status of serum vitamin D level on the outcome of ventilator associated pneumonia (VAP) in neonates.
Methods: This prospective cohort study was carried out on 60 intubated neonates with gestational age > 32 weeks and ventilated for more than 48 h and included two groups, VAP group (n=30) and non-VAP group (n=30). Serum 25-hydroxy Vit D was tested at the start of mechanical ventilation, while blood culture and endotracheal culture were obtained after 2 days of mechanical ventilation and when VAP was suspected.
Results: The mean serum level of vitamin D in VAP group was statistically significantly lower than non-VAP group. Also, the total duration of mechanical ventilation, duration of O2 supplementation post extubation and duration of hospital stay were statistically significantly longer in VAP group. Although the mortality was higher in neonates developed VAP, it didn’t achieve a statistically significant difference. A cut off value of ≤17.35 ng/ml of serum 25-hydroxy vitamin D showed a sensitivity of 83.33%, specificity of 100% and area under curve (AUC) was 0.895 to predict neonatal VAP.
Conclusion: 25-hydroxy vitamin D deficiency is an important risk factor for VAP development in neonates, and low vitamin D levels is associated with significant longer duration of mechanical ventilation, post extubation O2 support and hospital stay in neonates with VAP.