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Introduction: Nosocomial infections (NI) are common conditions among hospitalized patients. This study aimed to evaluate healthcare workers' knowledge and practices regarding infection prevention measures in intensive care units. Method: This was a descriptive, cross-sectional study conducted from April 13to June 10, 2022, among 45 healthcare workers in three university teaching hospitals of Abidjan. The parameters studied were: the theoretical and practical knowledge of healthcare workers regarding the prevention of nosocomial infections. Results: 45 healthcare workers participated. 74.7% knew the definition of a nosocomial infection and 43% identified the main risk factors for its occurrence. Sixty-five percent identified staff hands as the main mode of cross-transmission of germs between patients. Sixty-four percent of staff reported using non-sterile gloves during urinary catheter insertion. Compliance with hand hygiene before patient contact was low (31.8%) while gloves changes between patients were observed in 87.2% of cases. Deficiencies were noted in adherence to aseptic techniques before performing invasive procedures. Non-compliance was mainly attributed to shortages of supplies and personnel, and insufficient knowledge of preventive measures. Conclusion: healthcare workers’ knowledge and adherence to hygiene practices in intensive care units were insufficient.

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Introduction: enteral nutrition is a key component of the management of critically ill patients. The objective was to describe the current practices of enteral nutrition support among admitted patients in the polyvalent intensive care units of two university hospitals in Abidjan. Methods: it was a retrospective descriptive study. Socio-demographic, clinical, outcome related and nutritional parameters were analyzed along the biochemical composition of blended fluid feeds. Results: a total of 101 patients (55 in one center and 46 in the other) were included. Men represented 60% and the mean age was 45.69 years. Neurological disorders were the leading cause of admission (78.57%). Nutritional status could not be reliably assessed, as weight and height were recorded in only 62.16% and 16% of patients respectively. Likewise, biological markets of malnutrition risk (albumin, transthyretin and CRP) were not routinely ordered. The mean length of stay was 10.8+- 3.79 days, and mortality was high (69.1%). Conclusion: these findings strongly support the need to implement systematic nutritional assessment ad structured enteral feeding protocols in the ICU with the aim of improving patients’ outcomes.

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Introduction: Obstetric bleeding is bleeding during pregnancy that occurs before, during or after childbirth. They can evolve very quickly towards hemorrhagic shock even in patients without known risk factors. The management of these pathological conditions must not give way to improvisation and must involve the obstetrician, the anesthetist-resuscitator, the midwives and the blood bank. Objective: Evaluate the management of cases of hemorrhagic shock in the peri-partum. Patients and Method: We conducted a retrospective, descriptive, and analytical study over a period of 3 years from January, 2022 to December 31th, 2024. We had included all the parturients who presented a hemorrhagic shock pre-operatively as well as those who presented a hemorrhagic shock occurred during surgery. Result: During the study period, we compared 62 patients with a frequency of hemorrhagic shock in obstetric emergency of 11.5%. The average age of the patients was 29.9 years with extremes of 19 and 43 years. Six patients presented a scarred uterus (9.67%). The most common cause of hemorrhagic shock was recurrent hematoma (46.8%) followed by postpartum hemorrhages (19.22%). Disorders of consciousness were present at the installation in 19% of patients and 85% had a Shock Index greater than 0.9. General anesthesia was used in 98.4% of patients including those for whom spinal anesthesia was converted. A transfusion was made in 64.5% of the patients with an average of 0.73 units of blood per patient. Vasopressors (Noradrenaline ++) were administered to 82.3% of the patients. We had recorded 4 maternal deaths (6.45%) and 79% of perinatal deaths. Conclusion: Hemorrhagic shock constitutes extreme therapeutic emergencies in obstetrics. The anesthetist-resuscitator plays a leading role in managing the complications caused by this pathology. Our study highlights the need to improve the availability of labile blood products in our health structures.

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Introduction: The aim of our study was to report on our experience in paediatric anaesthesia and describe the difficulties encountered. Patients and Methods: This was a retrospective, descriptive study conducted from 14 August 2024 to 14 August 2025 in the anaesthesia department of the gynaecology and paediatrics unit at Cocody University Hospital. All children aged between 12 hours and 18 years admitted to the operating theatre were included in the study. The parameters studied were epidemiological, anaesthetic and post-operative data. Results: We collected data on 390 patients. The average age of the patients was 9.7 ± 3.4 years (range 12 months to 18 years). The sex ratio (M/F) was 2.8. All patients underwent a pre-anaesthetic consultation and the majority of them were classified as ASA I (75.94%). All anaesthesia was performed by a team of anaesthetists and state-registered anaesthetic nurses (100%). General anaesthesia was the most commonly used technique (71.28%). The average duration of anaesthesia was 30.2 ± 16 minutes (range: 25 to 420 minutes). Analgesic therapy was multimodal. Mortality was 0.51%. Other discharge modalities were admission to paediatric surgery (99.2%) and paediatric intensive care (0.33%). Conclusion: Promoting the training of paediatric anaesthetists and building more hospitals exclusively for children would improve the situation.

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Introduction: Obstetric complications remain a major cause of maternal morbidity and mortality in sub-Saharan Africa, particularly when intensive care is required. This study aimed to analyse the epidemiological, clinical, therapeutic and prognostic aspects of these complications. Methods: We conducted a 12-month descriptive and analytical study (March 2024 to February 2025) in the general intensive care unit (ICU) of CHU Gabriel Touré. All women admitted for obstetric complications were included. Data were entered and analysed using SPSS® 22.0. Results: Of 674 ICU admissions, 244 involved obstetric complications (36.2%). Mean age was 25.7 ± 7.1 years. Most patients were housewives (80%) and primigravidae (34.4%); over three-quarters (76.2%) had no antenatal care. Clinical findings included tachycardia (45%), arterial hypertension (45%), hypotension (35%) and anaemia (65%). The main obstetric complications were eclampsia (43%), retroplacental haematoma (36%), haemorrhagic shock (33.6%) and acute kidney injury (22.9%). Management comprised initial stabilisation (100%), oxygen therapy (39.7%), ventilatory support (50%), and blood transfusion (36.5%), predominantly red cell concentrates (65.1%). Magnesium sulphate (29.5%) and antihypertensives (25%) were used; noradrenaline was the vasopressor of choice (98%). Mean length of stay was 2.8 ± 2.32 days. Mortality was 17.6%. Prognostic analysis showed significant associations between mortality and eclampsia (p=0.000; RR=4.65 [2.04–10.62]), acute kidney injury (p=0.000; RR=3.12 [1.83–5.65]) and haemorrhagic shock (p=0.000; RR=2.75 [1.58–4.79]). Conclusion: Obstetric complications are frequent and carry substantial mortality. Strengthening antenatal care and ensuring timely, protocol-driven management are essential to improve maternal outcomes.

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The higher education sector is undergoing a significant transformation as universities increasingly adopt online learning as a strategic tool for expanding access, promoting flexibility, and enhancing competitiveness. In Kenya, private universities within the Nairobi Metropolitan Area have embraced online programs to remain competitive in a rapidly digitalized academic landscape. However, the performance of online programs, remains inconsistent across institutions. This study examined the effect of focus strategy on the performance of online programs among private universities in the Nairobi Metropolitan Area, Kenya. The study adopted a positivist philosophical paradigm and a cross-sectional explanatory research design. Data were collected from 149 respondents drawn from 20 private universities using stratified random sampling. Descriptive and inferential statistics were computed using SPSS version 29.0, with diagnostics conducted to confirm normality, multicollinearity, and homoscedasticity assumptions. The results indicated a statistically significant and positive relationship between focus strategy and performance of online programs (R=0.573; R²=0.328; F=71.819; p<0.05). The regression coefficient (B=0.527, t=8.475, p<0.05) showed that a unit increase in focus strategy leads to a 0.527-unit improvement in online program performance. These findings suggest that universities implementing targeted market segmentation, customized content delivery, and distinct marketing initiatives record superior outcomes in enrolment, completion, and ranking performance. The study concludes that focus strategy significantly enhances institutional competitiveness and sustainability by aligning educational offerings with the specific needs of niche markets. The study recommends that university management should institutionalize focus strategies through specialized program design, adaptive digital content, and niche marketing to attract and retain specific learner groups. Policy maker

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Background: Laryngomalacia is a congenital or, less commonly, acquired condition characterized by dynamic collapse of the supraglottic structures during inspiration. It is the leading cause of inspiratory stridor in infants, accounting for approximately 60%–75% of cases globally. The pathophysiology involves flaccid laryngeal tissues particularly the arytenoid cartilages, aryepiglottic folds, and epiglottis leading to airway obstruction when negative intrathoracic pressure increases during inhalation. The condition is generally classified as mild, moderate, or severe, based on symptom severity, impact on feeding and growth, and respiratory compromise. While the majority of mild cases resolve spontaneously by 18 to 24 months, more severe forms may result in significant complications including hypoxia, feeding difficulties, gastroesophageal reflux, failure to thrive, obstructive sleep apnea, and developmental delays. In such cases, conservative approaches like anti-reflux therapy and positional feeding may prove inadequate, necessitating surgical interventions such as supraglottoplasty or tracheostomy. In low-resource settings like Zanzibar, timely diagnosis and access to specialized surgical interventions are often limited. This increases the risk of progression from mild to life-threatening forms due to diagnostic delays, lack of equipment such as flexible laryngoscopes, and inadequate neonatal monitoring systems. Additionally, healthcare worker training in neonatal airway disorders is often insufficient in remote areas. This case report illustrates how prompt recognition, referral, and surgical management in such a setting led to a successful outcome, despite initial challenges.