Innovative Journal of Medical and Health Sciences

The aim of the research was to examine the linguistic structure of the written form
of communication for deaf children through the use of simple and complex written
sentences, questions asked and answers to questions asked, as well as the extent of the
used statements and messages in the form of expression. The study was conducted
on a sample of 70 deaf children. As a measurement instrument, letters of deaf
respondents were used on topics of their choice. In total, 45 communication contents,
written correspondence were analyzed. The content analysis method and the method
of descriptive analysis were used for data processing. The research results have
shown that the questions were not grammatically correct but the respondents understood
their essence and adequately responded to them, that although sentences
were not linguistically properly written, deaf children can use the dialogue in written
communication, that the respondents have problems in writing complex sentences but
that there is a possibility of using complex sentences, that the highest percentage of
respondents did not use complex sentences correctly, but over 17 % of respondents
can use syntaxically correctly written complex sentences in the form of communication
that deaf children understand the messages in a written form of communication.
Deaf children in written communication have communication but not the linguistic
competence.

The aim of the research was to examine the linguistic structure of the written form
of communication for deaf children through the use of simple and complex written
sentences, questions asked and answers to questions asked, as well as the extent of the
used statements and messages in the form of expression. The study was conducted
on a sample of 70 deaf children. As a measurement instrument, letters of deaf
respondents were used on topics of their choice. In total, 45 communication contents,
written correspondence were analyzed. The content analysis method and the method
of descriptive analysis were used for data processing. The research results have
shown that the questions were not grammatically correct but the respondents understood
their essence and adequately responded to them, that although sentences
were not linguistically properly written, deaf children can use the dialogue in written
communication, that the respondents have problems in writing complex sentences but
that there is a possibility of using complex sentences, that the highest percentage of
respondents did not use complex sentences correctly, but over 17 % of respondents
can use syntaxically correctly written complex sentences in the form of communication
that deaf children understand the messages in a written form of communication.
Deaf children in written communication have communication but not the linguistic
competence.

The aim of the research was to examine the linguistic structure of the written form
of communication for deaf children through the use of simple and complex written
sentences, questions asked and answers to questions asked, as well as the extent of the
used statements and messages in the form of expression. The study was conducted
on a sample of 70 deaf children. As a measurement instrument, letters of deaf
respondents were used on topics of their choice. In total, 45 communication contents,
written correspondence were analyzed. The content analysis method and the method
of descriptive analysis were used for data processing. The research results have
shown that the questions were not grammatically correct but the respondents understood
their essence and adequately responded to them, that although sentences
were not linguistically properly written, deaf children can use the dialogue in written
communication, that the respondents have problems in writing complex sentences but
that there is a possibility of using complex sentences, that the highest percentage of
respondents did not use complex sentences correctly, but over 17 % of respondents
can use syntaxically correctly written complex sentences in the form of communication
that deaf children understand the messages in a written form of communication.
Deaf children in written communication have communication but not the linguistic
competence.

The aim of the research was to examine the linguistic structure of the written form
of communication for deaf children through the use of simple and complex written
sentences, questions asked and answers to questions asked, as well as the extent of the
used statements and messages in the form of expression. The study was conducted
on a sample of 70 deaf children. As a measurement instrument, letters of deaf
respondents were used on topics of their choice. In total, 45 communication contents,
written correspondence were analyzed. The content analysis method and the method
of descriptive analysis were used for data processing. The research results have
shown that the questions were not grammatically correct but the respondents understood
their essence and adequately responded to them, that although sentences
were not linguistically properly written, deaf children can use the dialogue in written
communication, that the respondents have problems in writing complex sentences but
that there is a possibility of using complex sentences, that the highest percentage of
respondents did not use complex sentences correctly, but over 17 % of respondents
can use syntaxically correctly written complex sentences in the form of communication
that deaf children understand the messages in a written form of communication.
Deaf children in written communication have communication but not the linguistic
competence.

Introduction: Bronchopulmonary cancers are a major public health problem. It is
the leading cause of cancer death worldwide. Our goal is to evaluate the peculiarities
of bronchopulmonary cancers seen at the tiertiary hospital of Pneumology of
Befelatanana.
Material and methods: This is a retrospective, descriptive study of bronchopulmonary
cancers diagnosed at the tiertiary hospital of Pneumology Befelatanana during
the period from 1st January 2011 to 31st December, 2015 (5 years). We included
in the study all inpatients during the study period who were diagnosed with bronchopulmonary
cancer with histopathological evidence.
Results: During the period of our study, we found 43 patients with histologically
confirmed bronchopulmonary cancer, representing 0.64% of hospitalized patients. The
average age was 58 years old with an extreme ranging from 36 years old to 74 years
old. We found a male predominance with a sex ratio 1.38. Tabaco smoking was found
in 29 (32.55%) cases with a male predominance ie 22 (75.87%) male patients versus 7
(24.13%) female smoking patients ( P = 0.001). The histological type was dominated
by adenocarcinoma, found in 19 cases (44.18%), followed by squamous cell carcinoma,
found in 14 cases (32.56%). The diagnosis was made in 76.74% of cases in stage IV
according to the TNM classification.
Conclusion: The prevalence of bronchopulmonary cancer seen at the USFR Befelatanana
Pneumology is 0.64%. It is necessary to create a common database that collects
data throughout Madagascar in order to know the exact prevalence of this pathology
in our country.

Introduction: Bronchopulmonary cancers are a major public health problem. It is
the leading cause of cancer death worldwide. Our goal is to evaluate the peculiarities
of bronchopulmonary cancers seen at the tiertiary hospital of Pneumology of
Befelatanana.
Material and methods: This is a retrospective, descriptive study of bronchopulmonary
cancers diagnosed at the tiertiary hospital of Pneumology Befelatanana during
the period from 1st January 2011 to 31st December, 2015 (5 years). We included
in the study all inpatients during the study period who were diagnosed with bronchopulmonary
cancer with histopathological evidence.
Results: During the period of our study, we found 43 patients with histologically
confirmed bronchopulmonary cancer, representing 0.64% of hospitalized patients. The
average age was 58 years old with an extreme ranging from 36 years old to 74 years
old. We found a male predominance with a sex ratio 1.38. Tabaco smoking was found
in 29 (32.55%) cases with a male predominance ie 22 (75.87%) male patients versus 7
(24.13%) female smoking patients ( P = 0.001). The histological type was dominated
by adenocarcinoma, found in 19 cases (44.18%), followed by squamous cell carcinoma,
found in 14 cases (32.56%). The diagnosis was made in 76.74% of cases in stage IV
according to the TNM classification.
Conclusion: The prevalence of bronchopulmonary cancer seen at the USFR Befelatanana
Pneumology is 0.64%. It is necessary to create a common database that collects
data throughout Madagascar in order to know the exact prevalence of this pathology
in our country.

Introduction: Bronchopulmonary cancers are a major public health problem. It is
the leading cause of cancer death worldwide. Our goal is to evaluate the peculiarities
of bronchopulmonary cancers seen at the tiertiary hospital of Pneumology of
Befelatanana.
Material and methods: This is a retrospective, descriptive study of bronchopulmonary
cancers diagnosed at the tiertiary hospital of Pneumology Befelatanana during
the period from 1st January 2011 to 31st December, 2015 (5 years). We included
in the study all inpatients during the study period who were diagnosed with bronchopulmonary
cancer with histopathological evidence.
Results: During the period of our study, we found 43 patients with histologically
confirmed bronchopulmonary cancer, representing 0.64% of hospitalized patients. The
average age was 58 years old with an extreme ranging from 36 years old to 74 years
old. We found a male predominance with a sex ratio 1.38. Tabaco smoking was found
in 29 (32.55%) cases with a male predominance ie 22 (75.87%) male patients versus 7
(24.13%) female smoking patients ( P = 0.001). The histological type was dominated
by adenocarcinoma, found in 19 cases (44.18%), followed by squamous cell carcinoma,
found in 14 cases (32.56%). The diagnosis was made in 76.74% of cases in stage IV
according to the TNM classification.
Conclusion: The prevalence of bronchopulmonary cancer seen at the USFR Befelatanana
Pneumology is 0.64%. It is necessary to create a common database that collects
data throughout Madagascar in order to know the exact prevalence of this pathology
in our country.

Background: Breast augmentation using polyacrylamide hydrogel (PAAG) are frequently
associated with chronic persistent infection. However, emphysematous mastitis
with necrotizing fasciitis of the breast following using PAAG injection is very rare.
Case Report: A 31 years old female presented with bilateral breast pain, swelling,
redness, foul smelling discharge and fever for 24 hours. The patient had injection of
hydrogel in her both breasts for breast augmentation approximately 3 months ago.
The patient was mildly tachycardic with an elevated WBC(15x103). Examination
of breast revealed grossly swollen both breast(left> right), redness of the skin and
two obvious ulceration on the upper quadrant of left breast with pus like discharge.
On palpation both breasts were warm to touch, tender and sub-cutaneous crepitation
was felt over the both breast. The patient was started with empiric broad spectrum
antibiotic and consented for bilateral incision and drainage of breast abscess. Intra-op
findings revealed necrotising fasciitis of the subcutaneous fat of the entire both breast
except its attachment with the nipple areolar complex. Multiple debridement along
with VAC dressing were done. The right breast healed well with preservation of breast
shape however, the left breast becomes disfigured w ith s ignificant sk in lo ss, he nce a
toilet mastectomy and delayed autologous flap r econstruction w as d one o n h er left
breast.
Discussion: Complications of breast augmentation with PAAG injection can varies
from simple breast lumps, bleeding, pain, inflammation, m igration o f g el t o v ery a
rare life threating infection. These complications can be immediate and very late even
after many years later. High index of suspicion should be kept for early recognition,
diagnosis and treatment of PAAG-related complications. MRI of the breast is the
most reliable screening method for the detection of masses following PAAG augmentation.
Different t reatment a ttempts h ave b een m ade t o t reat t hese complications
from conservative to surgery and those with acute infections undergo a two stage procedure;
at first, w ide d ebridement a nd c ontrol o f s epsis a nd l ater o n d elayed breast
reconstruction.
Conclusion: Great care should be taken during insertion of PAAG for breast augmentation.
Strict follow up protocol should be implemented to identify any potential
complication at its earliest time. High index of suspicion should be kept for early
recognition, diagnosis and treatment. Appropriate steps should be taken to prevent
further morbidity and disfigurement. W e p resent a y oung f emale p atient w ith emphysematous
mastitis and necrotising fasciitis following hydrogel injection for breast
augmentation.

Background: Breast augmentation using polyacrylamide hydrogel (PAAG) are frequently
associated with chronic persistent infection. However, emphysematous mastitis
with necrotizing fasciitis of the breast following using PAAG injection is very rare.
Case Report: A 31 years old female presented with bilateral breast pain, swelling,
redness, foul smelling discharge and fever for 24 hours. The patient had injection of
hydrogel in her both breasts for breast augmentation approximately 3 months ago.
The patient was mildly tachycardic with an elevated WBC(15x103). Examination
of breast revealed grossly swollen both breast(left> right), redness of the skin and
two obvious ulceration on the upper quadrant of left breast with pus like discharge.
On palpation both breasts were warm to touch, tender and sub-cutaneous crepitation
was felt over the both breast. The patient was started with empiric broad spectrum
antibiotic and consented for bilateral incision and drainage of breast abscess. Intra-op
findings revealed necrotising fasciitis of the subcutaneous fat of the entire both breast
except its attachment with the nipple areolar complex. Multiple debridement along
with VAC dressing were done. The right breast healed well with preservation of breast
shape however, the left breast becomes disfigured w ith s ignificant sk in lo ss, he nce a
toilet mastectomy and delayed autologous flap r econstruction w as d one o n h er left
breast.
Discussion: Complications of breast augmentation with PAAG injection can varies
from simple breast lumps, bleeding, pain, inflammation, m igration o f g el t o v ery a
rare life threating infection. These complications can be immediate and very late even
after many years later. High index of suspicion should be kept for early recognition,
diagnosis and treatment of PAAG-related complications. MRI of the breast is the
most reliable screening method for the detection of masses following PAAG augmentation.
Different t reatment a ttempts h ave b een m ade t o t reat t hese complications
from conservative to surgery and those with acute infections undergo a two stage procedure;
at first, w ide d ebridement a nd c ontrol o f s epsis a nd l ater o n d elayed breast
reconstruction.
Conclusion: Great care should be taken during insertion of PAAG for breast augmentation.
Strict follow up protocol should be implemented to identify any potential
complication at its earliest time. High index of suspicion should be kept for early
recognition, diagnosis and treatment. Appropriate steps should be taken to prevent
further morbidity and disfigurement. W e p resent a y oung f emale p atient w ith emphysematous
mastitis and necrotising fasciitis following hydrogel injection for breast
augmentation.

Background: Breast augmentation using polyacrylamide hydrogel (PAAG) are frequently
associated with chronic persistent infection. However, emphysematous mastitis
with necrotizing fasciitis of the breast following using PAAG injection is very rare.
Case Report: A 31 years old female presented with bilateral breast pain, swelling,
redness, foul smelling discharge and fever for 24 hours. The patient had injection of
hydrogel in her both breasts for breast augmentation approximately 3 months ago.
The patient was mildly tachycardic with an elevated WBC(15x103). Examination
of breast revealed grossly swollen both breast(left> right), redness of the skin and
two obvious ulceration on the upper quadrant of left breast with pus like discharge.
On palpation both breasts were warm to touch, tender and sub-cutaneous crepitation
was felt over the both breast. The patient was started with empiric broad spectrum
antibiotic and consented for bilateral incision and drainage of breast abscess. Intra-op
findings revealed necrotising fasciitis of the subcutaneous fat of the entire both breast
except its attachment with the nipple areolar complex. Multiple debridement along
with VAC dressing were done. The right breast healed well with preservation of breast
shape however, the left breast becomes disfigured w ith s ignificant sk in lo ss, he nce a
toilet mastectomy and delayed autologous flap r econstruction w as d one o n h er left
breast.
Discussion: Complications of breast augmentation with PAAG injection can varies
from simple breast lumps, bleeding, pain, inflammation, m igration o f g el t o v ery a
rare life threating infection. These complications can be immediate and very late even
after many years later. High index of suspicion should be kept for early recognition,
diagnosis and treatment of PAAG-related complications. MRI of the breast is the
most reliable screening method for the detection of masses following PAAG augmentation.
Different t reatment a ttempts h ave b een m ade t o t reat t hese complications
from conservative to surgery and those with acute infections undergo a two stage procedure;
at first, w ide d ebridement a nd c ontrol o f s epsis a nd l ater o n d elayed breast
reconstruction.
Conclusion: Great care should be taken during insertion of PAAG for breast augmentation.
Strict follow up protocol should be implemented to identify any potential
complication at its earliest time. High index of suspicion should be kept for early
recognition, diagnosis and treatment. Appropriate steps should be taken to prevent
further morbidity and disfigurement. W e p resent a y oung f emale p atient w ith emphysematous
mastitis and necrotising fasciitis following hydrogel injection for breast
augmentation.

Background: Breast augmentation using polyacrylamide hydrogel (PAAG) are frequently
associated with chronic persistent infection. However, emphysematous mastitis
with necrotizing fasciitis of the breast following using PAAG injection is very rare.
Case Report: A 31 years old female presented with bilateral breast pain, swelling,
redness, foul smelling discharge and fever for 24 hours. The patient had injection of
hydrogel in her both breasts for breast augmentation approximately 3 months ago.
The patient was mildly tachycardic with an elevated WBC(15x103). Examination
of breast revealed grossly swollen both breast(left> right), redness of the skin and
two obvious ulceration on the upper quadrant of left breast with pus like discharge.
On palpation both breasts were warm to touch, tender and sub-cutaneous crepitation
was felt over the both breast. The patient was started with empiric broad spectrum
antibiotic and consented for bilateral incision and drainage of breast abscess. Intra-op
findings revealed necrotising fasciitis of the subcutaneous fat of the entire both breast
except its attachment with the nipple areolar complex. Multiple debridement along
with VAC dressing were done. The right breast healed well with preservation of breast
shape however, the left breast becomes disfigured w ith s ignificant sk in lo ss, he nce a
toilet mastectomy and delayed autologous flap r econstruction w as d one o n h er left
breast.
Discussion: Complications of breast augmentation with PAAG injection can varies
from simple breast lumps, bleeding, pain, inflammation, m igration o f g el t o v ery a
rare life threating infection. These complications can be immediate and very late even
after many years later. High index of suspicion should be kept for early recognition,
diagnosis and treatment of PAAG-related complications. MRI of the breast is the
most reliable screening method for the detection of masses following PAAG augmentation.
Different t reatment a ttempts h ave b een m ade t o t reat t hese complications
from conservative to surgery and those with acute infections undergo a two stage procedure;
at first, w ide d ebridement a nd c ontrol o f s epsis a nd l ater o n d elayed breast
reconstruction.
Conclusion: Great care should be taken during insertion of PAAG for breast augmentation.
Strict follow up protocol should be implemented to identify any potential
complication at its earliest time. High index of suspicion should be kept for early
recognition, diagnosis and treatment. Appropriate steps should be taken to prevent
further morbidity and disfigurement. W e p resent a y oung f emale p atient w ith emphysematous
mastitis and necrotising fasciitis following hydrogel injection for breast
augmentation.