ABSTRACT
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.

ABSTRACT
Takotsubo syndrome (TTS) is an acute reversible cardiomyopathy mimicking acute coronary syndrome (ACS), characterized by transient left ventricular dysfunction. It usually occurs after intense emotional or physical stress. Few cases of TSS in a perioperative setting have been described in the literature. However, recent literature data show an increase in its incidence in the perioperative period in recent years. The prognosis is generally favorable, but the outcome can often be rapidly fatal. We report a case of Takotsubo syndrome that occurred immediately after surgery in a 55-year-old patient with chronic coronary artery disease who underwent right middle lobectomy with lymph node dissection. The event was triggered by an episode of severe hypoxia and an injection of adrenaline. The diagnosis was confirmed by echocardiography (LVEF 25%, circumferential apical akinesis) and coronary angiography (chronic bifocal stenosis without acute occlusion). The outcome was favorable after symptomatic treatment and hemodynamic suppor, with complete recovery of left ventricular function. This observation illustrates the possibility of TST in a surgical setting in coronary patients. We also describe the diagnostic and therapeutic aspects of this rare perioperative complication.

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This essay uses the narrative approach to reflect on Luke 24:13-35 in relation to the ministry of healthcare Chaplains besides its application to various theological and pastoral paradigms. It illustrates how the text inspires spiritual accompaniment, informs spiritual assessment, directs pastoral interventions, and guides boundaries in pastoral care for the sick in healthcare settings. It encourages Chaplains to foster and evoke the attitude of compassionate curiosity in patients to aid them engage with the truth of their own health conditions, no matter what, to find meaning, strength and hope in their own sufferings and pain. It finally invites Chaplains to consider their role as a prophetic witness to the truth of the mystery of the human being. Against the backdrop of the story, the article ignites the reader to search for answers to the questions: What is the context of hospital chaplaincy ministry discovered in Luke 24:13-35? What pastoral attitudes of Jesus are evident in the gospel pericope? And how do these pastoral attitudes serve as the “Jesus-factor" to inform the decision and skills of Christian Chaplains on the one hand and inspires Healthcare Chaplaincy Ministry in general on the other hand?

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Background: Ventilator-associated pneumonia (VAP) is a common nosocomial infection in intensive care units, associated with high morbidity and mortality. Stenotrophomonas maltophilia has emerged as an opportunistic pathogen in critically ill patients, particularly following prolonged mechanical ventilation and prior antibiotic exposure. Methods: We conducted a retrospective multicenter study over a 4-year period in three intensive care units in France. Adult patients with VAP caused by S. maltophilia were included. Clinical, microbiological, and therapeutic data were collected. The primary outcome was 28-day mortality. Results: Among 293 VAP episodes caused by non-fermenting Gram-negative bacilli, 28 (9.55%) were due to S. maltophilia. Patients were elderly, highly comorbid, and severely ill, with a high rate of septic shock (71.1%). Polymicrobial infections were frequent (75%), mainly involving Enterobacterales. Empirical antibiotic therapy was active in only 14.3% of cases. Targeted therapy mainly relied on trimethoprim–sulfamethoxazole or levofloxacin. The 28-day mortality rate was 60.7%, with early deaths observed after diagnosis. Conclusion: S. maltophilia VAP occurs in high-risk ICU patients and is associated with frequent polymicrobial infections, inadequate empirical therapy, and high mortality, highlighting the need for improved management strategies.

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Introduction: Obstetric emergencies are a major cause of maternal and foetal morbidity and mortality, particularly in sub-Saharan Africa where healthcare resources are limited. Emergency caesarean sections, whilst life-saving, are often performed under adverse conditions, requiring appropriate anaesthetic management. Improvements in anaesthetic techniques, particularly regional anaesthesia, have helped to reduce complications, but disparities persist between low- and high-income countries. Patients and Methods: This was a retrospective descriptive and analytical study conducted over a six-month period (1 August 2024 to 31 January 2025) at the ‘Le Luxembourg’ Mother and Child University Hospital in Bamako. The study included all women who underwent an emergency caesarean section with anaesthetic management. The variables studied included sociodemographic characteristics, surgical indications, anaesthetic techniques, perioperative incidents, and maternal and foetal outcomes. Results: Of the 191 caesarean sections performed, 77 were emergency caesarean sections, representing a rate of 40.31%. The mean age of the patients was 27.85 years. The main indications were acute foetal distress (26%), dystocia (19.5%) and severe pre-eclampsia (14.2%). Spinal anaesthesia was the most commonly used technique (75%), compared with 25% for general anaesthesia. Intraoperative complications were dominated by arterial hypotension (10.38%), haemorrhagic shock (6.4%) and nausea/vomiting (7.89%). Admission to the intensive care unit was required in 18.20% of patients. Perioperative maternal mortality was 3.89%. Discussion: The high frequency of emergency caesarean sections observed in our study reflects the difficulties in accessing routine obstetric care and delays in management, which are common in sub-Saharan Africa. Despite the predominant use of spinal anesthesia in line with international recommendations, the continued high use of general anesthesia highlights the severity of clinica

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Background: Acute respiratory distress is a major cause of morbidity and mortality in critical care, particularly in resource-limited settings where access to conventional imaging is often delayed. Point-of-care lung ultrasound (POCUS) has emerged as a rapid, reproducible, and non-invasive bedside tool that enables early etiological assessment, guides timely therapeutic decisions, and may improve patient outcomes. We aimed to evaluate the effect of early POCUS on in-hospital mortality among patients admitted with acute respiratory distress to the intensive care unit of the Essos Hospital Center. Methods: We performed a prospective observational study in the intensive care unit of the Essos Hospital Center. All consecutive adult (≥18 years) patients admitted with acute respiratory distress over a 12-month period were included. Patients were stratified into two groups based on whether early point-of-care lung ultrasound (POCUS) was performed within the first hour of admission by a trained physician. Demographic, clinical, echocardiographic, diagnostic, and outcome data were collected prospectively. The primary outcome was in-hospital mortality, and secondary outcomes included time to definitive diagnosis and identification of the primary etiology.

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Background: Delays in the administration of analgesia remain common in emergency departments, with more than 75% of patients experiencing treatment delays exceeding 60 minutes. This persistent undertreatment contributes to oligoanalgesia and avoidable patient suffering. Objective: To evaluate the effect of implementing an early analgesia protocol on time to pain management in the emergency department of Essos Hospital Center over a 3-month period. Methods: We performed a quasi-experimental before-and-after study including 180 consecutive adult patients presenting with moderate to severe acute pain (visual analogue scale [VAS] ≥4). The intervention consisted of a standardised, protocol-driven analgesia algorithm combined with focused staff training. The primary outcome was the proportion of patients receiving analgesia within 30 minutes of triage. Secondary outcomes included median time to analgesic administration, pain intensity at 60 minutes (VAS), and patient satisfaction at 24 hours. Results: Following implementation of the protocol, the proportion of patients receiving analgesia within 30 minutes increased significantly from 21% to 66% (p<0.001). The median time to analgesic administration was reduced from 76 minutes (IQR, not reported) to 29 minutes, and mean pain scores at 60 minutes decreased from 6.2±1.3 to 3.3±1.0 (p<0.001). Patient satisfaction at 24 hours improved markedly, rising from 48% to 79% (p<0.001). Conclusion: The introduction of an early, protocol-driven analgesia strategy in the emergency department was associated with a substantial reduction in treatment delays and a clinically meaningful improvement in pain relief and patient satisfaction. These findings support the routine implementation of structured analgesia pathways to optimise the timely management of acute pain in resource-limited emergency care settings.