La tuberculose de la cavité buccale reste rare. Elle admet un polymorphisme clinique et pose avant tout un problème de diagnostic. Nous rapportons le cas d'un homme de 42 ans présentant une chéilite tuberculeuse. L’intérêt de cette présentation est d’attirer l’attention sur la tuberculose que l’on peut retrouver de façon exceptionnelle dans certaines localisations, comme la lèvre buccale.
Microbiologie (bactériologie, virologie)Maladies infectieuses et tropicalesLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The aim of this research was to evaluate the essential oil of Cymbopogon schoenanthus (L.) Spreng. (C. schoenanthus) from Burkina Faso in terms of cytotoxic activity against LNCaP cells, derived from prostate cancer, and HeLa cells, derived from cervical cancer. Antioxidant activities were evaluated in vitro. Essential oil (EO) was extracted by hydrodistillation and analyzed by GC/FID and GC/MS. Thirty-seven compounds were identified, the major compounds being piperitone (49.9%), δ-2-carene (24.02%), elemol (5.79%) and limonene (4.31%). EO exhibited a poor antioxidant activity, as shown by the inhibition of DPPH radicals (IC50 = 1730 ± 80 µg/mL) and ABTS+. (IC50 = 2890 ± 26.9 µg/mL). Conversely, EO decreased the proliferation of LNCaP and HeLa cells with respective IC50 values of 135.53 ± 5.27 µg/mL and 146.17 ± 11 µg/mL. EO also prevented LNCaP cell migration and led to the arrest of their cell cycle in the G2/M phase. Altogether, this work points out for the first time that EO of C. schoenanthus from Burkina Faso could be an effective natural anticancer agent.
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Anjanette DeCarlo, Stephen Johnson, Amadé Ouédraogo, Noura S. Dosoky, William N. Setzer
Frankincense, the oleogum resin from members of Boswellia, has been used as medicine and incense for thousands of years, and essential oils derived from frankincense are important articles of commerce today. A new source of frankincense resin, Boswellia dalzielii from West Africa has been presented as a new, alternative source of frankincense. In this work, the oleogum resins from 20 different Boswellia dalzielii trees growing in Burkina Faso, West Africa were collected. Hydrodistillation of the resins gave essential oils that were analyzed by GC-MS and GC-FID. The essential oils were dominated by α-pinene (21.0%–56.0%), followed by carvone (2.1%–5.4%) and α-copaene (1.8%–5.0%). Interestingly, there was one individual tree that, although rich in α-pinene (21.0%), also had a substantial concentration of myrcene (19.2%) and α-thujene (9.8%). In conclusion, the oleogum resin essential oil compositions of B. dalzielii, rich in α-pinene, are comparable in composition to other frankincense essential oils, including B. sacra, B. carteri, and B. frereana. Additionally, the differences in composition between samples from Burkina Faso and those from Nigeria are very slight. There is, however, a rare chemotype of B. dalzielii that is dominated by myrcene, found both in Burkina Faso as well as Nigeria.
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This research highlights the chemical composition, antioxidant, anti-inflammatory and anti-proliferative activities of essential oils from leaves of Ocimum basilicum, Ocimum americanum, Hyptis spicigera, Lippia multiflora, Ageratum conyzoides, Eucalyptus camaldulensis and Zingiber officinale. Essential oils were analyzed by gas chromatography–mass spectrometry and gas chromatography–flame ionization detector. Major constituents were α-terpineol (59.78%) and β-caryophyllene (10.54%) for Ocimum basilicum; 1, 8-cineol (31.22%), camphor (12.730%), α-pinene (6.87%) and trans α-bergamotene (5.32%) for Ocimum americanum; β-caryophyllene (21%), α-pinene (20.11%), sabinene (10.26%), β-pinene (9.22%) and α-phellandrene (7.03%) for Hyptis spicigera; p-cymene (25.27%), β-caryophyllene (12.70%), thymol (11.88), γ-terpinene (9.17%) and thymyle acetate (7.64%) for Lippia multiflora; precocene (82.10%)for Ageratum conyzoides; eucalyptol (59.55%), α-pinene (9.17%) and limonene (8.76%) for Eucalyptus camaldulensis; arcurcumene (16.67%), camphene (12.70%), zingiberene (8.40%), β-bisabolene (7.83%) and β-sesquiphellandrène (5.34%) for Zingiber officinale. Antioxidant activities were examined using 1,1-diphenyl-2-picryl-hydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid (ABTS) methods. O. basilicum and L. multiflora exhibited the highest antioxidant activity in DPPH and ABTS tests, respectively. Anti-inflammatory properties were evaluated by measuring the inhibition of lipoxygenase activity and essential oil of Z. officinale was the most active. Anti-proliferative effect was assayed by the measurement of MTT on LNCaP and PC-3 prostate cancer cell lines, and SF-763 and SF-767 glioblastoma cell lines. Essential oils from A. conyzoides and L. multiflora were the most active on LNCaP and PC-3 cell lines, respectively. The SF-767 glioblastoma cell line was the most sensitive to O. basilicum and L. multiflora EOs while essential oil of A. conyzoides showed the highest a
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Simple SummaryForage is a key component of ruminant diets. This study evaluates the nutritional quality of the main forage species in Burkina Faso to provide accurate data for cost-effective and balanced ration formulation. Several trials were conducted to assess the proximate composition, intake and digestibility of native and improved forages, including grasses and crop residues. The feed resources assessed included Brachiaria cv. Mulato II and Panicum maximum cv. Zuri straw, Andropogon gayanus hay (native forage), Panicum maximum cv. C1 hay, green fodder of Panicum maximum sp. and Brachiaria cv. Mulato II, and crop residues (maize and millet straw, cowpea and peanut haulms). Nutritional composition varied by species and harvest stage, with improved and native grasses harvested at stem elongation showing higher nutrient contents than cereal straws. Peanut and cowpea haulms contained more protein than green grass fodder. Among hay and straw, Panicum maximum cv. C1 was the most ingested feed by djalonke sheep, while legume haulms were more readily consumed than green fodder. Digestibility was greatest in peanut haulms. These findings enrich Burkina Faso’s feed database and support more effective livestock ration formulation. AbstractIn Burkina Faso, native and improved forage species and crop residues are widely used as feed resources for ruminant livestock. Accurate information on their chemical composition, digestibility, and voluntary intake is essential for balanced and cost-effective ration formulation. This study, conducted from 2021 to 2022 at the INERA research station with Djallonké sheep, evaluated the nutritional quality of key forage resources: Brachiaria cv. Mulato II, Panicum maximum cvs. Zuri and C1, Andropogon gayanus, maize and millet straws, and cowpea (Vigna unguiculata) and peanut (Arachis hypogaea) haulms. Four trials were conducted using six intact adult male sheep per forage. For each trial, the animals were fed ad libitum during a 14-day adap
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La mise en place de la tarification à l’activité (T2A) n’a pas été un long fleuve tranquille, puisqu’elle aura demandé plus de 20 ans de travail. Lamise place de la T2A est tardive par rapport aux autres pays du monde, mais elle est radicale, car on est passé d’un budget global à un financement à l’activité à 100%. Aux États Unis, le financement à l’activité touche uniquement les séjours des patients du programme Medicare.
Biostatistiques et épidémiologieSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/
BackgroundSub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight) within four sub-regions of sub-Saharan Africa.MethodsCross-sectional data from the most recent Demographic and Health Surveys (2006–2016) of 32 countries in sub-Saharan Africa were used. The countries were grouped into four sub-regions (East Africa, West Africa, Southern Africa and Central Africa), and a meta-analysis was conducted to estimate the prevalence of each malnutrition indicator within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed, to examine the effects of outliers. Stunting was defined as HAZ<-2; wasting as WHZ<-2 and underweight as WAZ<-2.ResultsStunting was highest in Burundi (57.7%) and Malawi (47.1%) in East Africa; Niger (43.9%), Mali (38.3%), Sierra Leone (37.9%) and Nigeria (36.8%) in West Africa; Democratic Republic of Congo (42.7%) and Chad (39.9%) in Central Africa. Wasting was highest in Niger (18.0%), Burkina Faso (15.50%) and Mali (12.7%) in West Africa; Comoros (11.1%) and Ethiopia (8.70%) in East Africa; Namibia (6.2%) in Southern Africa; Chad (13.0%) and Sao Tome & Principle (10.5%) in Central Africa. Underweight was highest in Burundi (28.8%) and Ethiopia (25.2%) in East Africa; Niger (36.4%), Nigeria (28.7%), Burkina Faso (25.7%), Mali (25.0%) in West Africa; and Chad (28.8%) in Central Africa.ConclusionThe prevalence of malnutrition was highest within countries in East Africa and West Africa compared to the WHO Millennium development goals target for 2015. Appropriate nutrition interventions need to be prioritised in East Africa and West Africa if sub-Saharan Africa is
Biostatistiques et épidémiologiePédiatrieGynécologie-obstétriqueLicence : Creative Commons Attribution License This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Britt McKinnon, Harriet L. MacMillan, Ashley Vandermorris, Katholiki Georgiades, Emma Nolan, Christina Catley, Isabelle Lvesque, Lil Tonmyr
AbstractThis study presents the first Canadian self-reported estimates of child maltreatment (CM) from youth using data from 5256 participants aged 15 to 17 years in the 2023 Canadian Health Survey on Children and Youth. CM prevalence was high, particularly for emotional abuse (44.9%) and exposure to caregiver emotional intimate partner violence (39.4%). Females reported higher prevalence of sexual abuse (8.1% vs. 1.5%) and emotional abuse (52.2% vs. 35.4%) than males. Youth identifying as nonbinary or with a gender different from their sex assigned at birth reported the highest prevalence across all CM types, including 22.4% for sexual abuse and 83.7% for emotional abuse. These finding underscore the need for targeted research and policies that address structural determinants of gender-based disparities.
Biostatistiques et épidémiologiePédiatrieSanté publiqueLicence : This work is licensed under a Creative Commons Attribution 4.0 International License
Obiageli E Nnodu, Assaf P Oron, Alayo Sopekan, Godwin O Akaba, Frédéric B Piel, Dennis L Chao
SummaryBackgroundChild mortality from sickle cell disease in sub-Saharan Africa is presumed to be high but is not well quantified. This uncertainty contributes to the neglect of sickle cell disease and delays the prioritisation of interventions. In this study, we estimated the mortality of children in Nigeria with sickle cell disease, and the proportion of national under-5 mortality attributable to sickle cell disease.MethodsWe did a model-estimated, population-level analysis of data from Nigeria's 2018 Demographic and Health Survey (DHS) to estimate the prevalence and geographical distribution of HbSS and HbSC genotypes assuming Hardy-Weinberg equilibrium near birth. Interviews for the survey were done between Aug 14 and Dec 29, 2018, and the embedded sickle cell disease survey was done in a randomly selected third of the overall survey's households. We developed an approach for estimating child mortality from sickle cell disease by combining information on tested children and their untested siblings. Tested children were aged 6–59 months at the time of the survey. Untested siblings born 0–14 years before the survey were also included in analyses. Testing as part of the DHS was done without regard to disease status. We analysed mortality differences using the inheritance-derived genotypic distribution of untested siblings older than the tested cohort, enabling us to estimate excess mortality from sickle cell disease for the older-sibling cohort (ie, those born between 2003 and 2013).FindingsWe analysed test results for 11 186 children aged 6–59 months from 7411 households in Nigeria. The estimated average birth prevalence of HbSS was 1·21% (95% CI 1·09–1·37) and was 0·24% (0·19–0·31) for HbSC. We obtained data for estimating child mortality from 10 195 tested children (who could be matched to the individual mother survey) and 17 205 of their untested siblings. 15 227 of the siblings were in the older-sibling cohort. The group of children with sickle cell disease bo
Biostatistiques et épidémiologieHématologiePédiatrieLicence : This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Background/Objectives: Extreme temperatures linked to climate change threaten child health, particularly in Sub-Saharan Africa where malnutrition remains widespread. This study examines how exposure to hot and cold temperature anomalies influences child stunting in Burkina Faso and Kenya and evaluates how household infrastructure and socio-demographic factors interact with climate stressors to shape outcomes. Methods: We combined nationally representative Demographic and Health Surveys (Burkina Faso 2021; Kenya 2022) with daily maximum and minimum temperature data from the Climate Hazards InfraRed Temperature with Stations (CHIRTS). The analytic sample included children aged 24–59 months. Temperature anomalies were calculated as standardized deviations from local historical averages. Multilevel logistic regression models assessed associations between stunting, climate anomalies, and household-level factors, including electricity, water, sanitation, wealth, and rural/urban residence. Results: Heat anomalies were linked to increased stunting risk in Kenya (β = 2.34, p < 0.001), while in Burkina Faso, higher maximum temperatures unexpectedly reduced stunting odds (β = 0.08, p < 0.05). Cold anomalies showed marginal positive associations with stunting in both countries. Infrastructure and socioeconomic factors varied by context: electricity access and urban residence were protective in Burkina Faso, while improved sanitation, household wealth, and child sex differences were significant in Kenya. Conclusions: Climate anomalies and household conditions jointly influence stunting among children aged 24–59 months, with effects varying by country. Cold anomalies were associated with higher odds of stunting in Burkina Faso (BF OR = 2.14) and Kenya (KE OR = 1.20), while heat anomalies reduced stunting in BF (OR = 0.08) but increased it in KE (OR = 2.34). Electricity access was protective in both countries (BF OR = 0.61; KE OR = 0.71), while improved water, sanitation, and weal
Biostatistiques et épidémiologiePédiatrieSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/ Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ().
Kristine Belesova, Antonio Gasparrini, Paul Wilkinson, Ali Sié, Rainer Sauerborn
AbstractPopulations that are reliant on subsistence farming are particularly vulnerable to climatic effects on crop yields. However, empirical evidence on the role of the timing of exposure to crop yield deficits in early-life development is limited. We examined the relationship between child survival and annual crop yield reductions at different stages of early-life development in a subsistence farming population in Burkina Faso. Using shared frailty Cox proportional hazards models adjusting for confounders, we analyzed 57,288 children under 5 years of age followed by the Nouna Health and Demographic Surveillance System (1994–2016) in relation to provincial food-crop yield levels experienced in 5 nonoverlapping time windows (12 months before conception, gestation, birth–age 5.9 months, ages 6.0 months–1.9 years, and ages 2.0–4.9 years) and their aggregates (birth–1.9 years, first 1,000 days from conception, and birth–4.9 years). Of the nonoverlapping windows, point estimates were largest for child survival related to food-crop yields for the time window of 6.0 months–1.9 years: The adjusted mortality hazard ratio was 1.10 (95% confidence interval: 1.03, 1.19) for a 90th-to-10th percentile yield reduction. These findings suggest that child survival in this setting is particularly vulnerable to cereal-crop yield reductions during the period of nonexclusive breastfeeding.
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Introduction: pemphigus vulgaris is a rare autoimmune blistering disease that involves the skin and mucous membranes and rarely occurs in pediatric age. Methods: we present a case of childhood pemphigus in a 9-year-old patient from Burkina Faso, which initially manifested with erosive lesions symmetrically distributed in the oral cavity. After a few months, we also observed hyperchromic lesions of the back. Histopathological examination of skin samples showed intraepidermal acantholysis, while direct immunofluorescence showed deposits of complement (C3) and immunoglobulins G (IgG) in the epidermidis; an ELISA test highlighted the presence of circulating autoantibodies against desmoglein 3. Results: the follow-up of this patient was made difficult by the advent of the COVID-19 outbreak. However, after about one year of combined therapy with systemic steroids and azathioprine the patient reached clinical remission.
ImmunologiePédiatrieSanté publiqueLicence : https://creativecommons.org/licenses/by/4.0/ Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ().
Christopher J Paciorek, Gretchen A Stevens, Mariel M Finucane, Majid Ezzati
SummaryBackgroundUrban living affects children's nutrition and growth, which are determinants of their survival, cognitive development, and lifelong health. Little is known about urban–rural differences in children's height and weight, and how these differences have changed over time. We aimed to investigate trends in children's height and weight in rural and urban settings in low-income and middle-income countries, and to assess changes in the urban–rural differentials in height and weight over time.MethodsWe used comprehensive population-based data and a Bayesian hierarchical mixture model to estimate trends in children's height-for-age and weight-for-age Z scores by rural and urban place of residence, and changes in urban–rural differentials in height and weight Z scores, for 141 low-income and middle-income countries between 1985 and 2011. We also estimated the contribution of changes in rural and urban height and weight, and that of urbanisation, to the regional trends in these outcomes.FindingsUrban children are taller and heavier than their rural counterparts in almost all low-income and middle-income countries. The urban–rural differential is largest in Andean and central Latin America (eg, Peru, Honduras, Bolivia, and Guatemala); in some African countries such as Niger, Burundi, and Burkina Faso; and in Vietnam and China. It is smallest in southern and tropical Latin America (eg, Chile and Brazil). Urban children in China, Chile, and Jamaica are the tallest in low-income and middle-income countries, and children in rural areas of Burundi, Guatemala, and Niger the shortest, with the tallest and shortest more than 10 cm apart at age 5 years. The heaviest children live in cities in Georgia, Chile, and China, and the most underweight in rural areas of Timor-Leste, India, Niger, and Bangladesh. Between 1985 and 2011, the urban advantage in height fell in southern and tropical Latin America and south Asia, but changed little or not at all in most other regions. T
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BackgroundThe sterile insect technique (SIT) requires mass-rearing of the target species, irradiation to induce sexual sterility and transportation from the mass-rearing facility to the target site. Those treatments require several steps that may affect the biological quality of sterile males. This study has been carried out to evaluate the relative impact of chilling, irradiation and transport on emergence rate, flight ability and survival of sterile male Glossina palpalis gambiensis.ResultsChilling, irradiation and transport all affected the quality control parameters studied. The emergence rate was significantly reduced by long chilling periods and transport, i.e. from 92% at the source insectary in Burkina Faso to 78% upon arrival in Senegal. Flight ability was affected by all three parameters with 31% operational flies lost between the production facility and the destination site. Only survival under stress was not affected by any of the treatments.ConclusionThe chilling period and transport were the main factors that impacted significantly the quality of sterile male pupae. Therefore, in the operational programme, the delivery of sterile male pupae was divided over two shipments per week to reduce the chilling time and improve the quality of the sterile males. Quality of the male pupae may further be improved by reducing the transport time and vibrations during transport.
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Henintsoa Murielle Rakotomalala, Andriatsihoarana Voahary Nasandratriniavo Ramahandrisoa, Malala Razakanaivo, Ny Ony Andrianandrasana, Florine Rafaramino
La prise en charge d´un cancer du sein associé à une grossesse constitue un défi pour les médecins qui vient souvent du désir de la mère de mener à terme la grossesse malgré la nécessité d´une chimiothérapie. Une femme de 37 ans, multipare, enceinte à 20 semaines d´aménorrhée (SA) et 4 jours a été hospitalisée pour dyspnée NYHA IV. La patiente présentait un syndrome d´épanchement pleural liquidien gauche de grande abondance et une mastite bilatérale. Le diagnostic de cancer du sein métastatique était retenu par un examen cytologique du liquide pleural et une cytoponction mammaire révélant un carcinome galactophorique. La patiente a bénéficié d´un drainage pleural avec amélioration de la dyspnée mais le liquide pleural restait intarissable. Après discussion en réunion de concertation pluridisciplinaire (RCP), un traitement spécifique du cancer était impératif. Cinq cycles de chimiothérapie du protocole associant le 5-Fluoro-uracile, Epirubicine et Cyclophosphamide avaient été réalisés après le consentement du couple. L´épanchement pleural avait fortement diminué après la deuxième cure. En concertation avec l´obstétricien, la chimiothérapie avait été arrêtée un mois avant la 37esemaine d´aménorrhée. L´évolution de la grossesse était favorable, l´accouchement est dirigé après rupture des membranes avec issu par voie basse d´un bébé né à terme avec une bonne adaptation néonatale. A un an du suivi, la mère est toujours en cours de chimiothérapie et le bébé est en bonne santé. Plusieurs paramètres sont à considérer lors de l´administration des antinéoplasiques d´où l'intérêt d'une surveillance fœtale et obstétricale rapprochée. Une approche multidisciplinaire est recommandée pour la décision thérapeutique et le suivi.
Gynécologie-obstétriqueLicence : https://creativecommons.org/licenses/by/4.0/ The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (), which permits unrestricted use, distribution, and reproduction in any medium, p
L'hyperthyroïdie englobe plusieurs maladies caractérisées par un niveau élevé d'hormones thyroïdiennes circulantes. La thyroïdectomie en est un des principaux traitements. L'objectif de notre étude est d'évaluer, à travers une étude rétrospective, les particularités épidémiologiques, cliniques, thérapeutiques, et évolutives des patients ayant bénéficié d'une prise en charge chirurgicale d'une hyperthyroïdie dans le service d'ORL à l'hôpital militaire Avicenne de Marrakech. Soixante patients ont été colligés avec une prédominance féminine et une moyenne d'âge de 52 ans. La clinique a été dominée par les signes de thyrotoxicoses qui ont été retrouvés chez tous les patients. L'exploration a permis d'identifier 47 cas de goitre multihétéronodulaire toxique ou prétoxique (soit 78.33% des cas), 5 cas de maladies de Basedow (soit 8.33%) et 8 cas d'adénome toxique (soit 13.33%). Une préparation médicale a été de mise chez tous nos patients. Une thyroïdectomie totale a été réalisée chez 50 patients (soit 83.33%) et une loboisthmectomie chez 10 patients (soit 16.33%). En post-opératoire, des complications sont été colligés: un cas de paralysie laryngée transitoire (1,6% des cas), neuf cas d'hypoparathyroïdie transitoire (15% des cas), un cas d'hypoparathyroïdie définitive (1,6% de cas), et un seul cas d'hématome compressif (1,6% de cas). La chirurgie des goitres toxiques réputés hémorragiques et adhérents, doit être réalisée par un chirurgien expérimenté qui doit doubler de vigilance pour minimiser la morbidité représentée essentiellement par la paralysie laryngée et l'hypoparathyroïdie.
Biostatistiques et épidémiologieSanté publiqueLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Arturo García PAVÍA, Fernando PEREIRA PÉREZ, Iñaki ERQUICIA PERALT, María Isabel HERRERA LÓPEZ, Eva María BURGOS JIMÉNEZ, Akana NGATIA ALEX, Ebune Jackson LOKILI
RésuméIntroductionLes résultats des campagnes de chirurgie thyroïdienne dans des populations disposant de faibles ressources sont rarement évalués.Matériel et méthodesUne campagne de 11 jours a été réalisée à l'hôpital dominicain Saint Martin de Porres. Les données démographiques, les valeurs de TSH, la chirurgie et les complications après 12 mois de suivi ont été analysées.RésultatsTrente-deux patients ont été opérés. Treize patients avaient un goitre bilatéral, 10 patients un goitre grade II de l'OMS. Dix-huit hémithyroïdectomies (lobo-isthmectomie), 13 thyroïdectomies totales et 1 thyroïdectomie totalisante ont été réalisées. À 12 mois, 3 patients présentaient une dysphonie légère et un patient présentait une hypocalcémie persistante. Le suivi a été effectué directement pour 24 patients ou par téléphone (8 patients) pour ceux ne pouvant se déplacer.ConclusionsUne série d’étapes importantes doit être respectée : participation active de l'entourage du patient, échographie thyroïdienne par l’équipe chirurgicale pour décider de la technique, sensibilisation intense à la surveillance et à l'hormonothérapie substitutive, et participation du personnel local pour un contrôle à long terme.
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Nous rapportons l’observation d’un choc anaphylactique survenue au cours d’une chirurgie de kystes hydatiques hépatiques multiples. Il s’agit d’un enfant de 13 ans, de sexe féminin, sans antécédents pathologiques notables, en particulier allergique, programmé pour cure chirurgicale de kystes hydatiques hépatiques multiples. L’examen préopératoire est strictement normal. La patiente est classée ASA (American Society of Anaesthesiologists) I. L’intervention est réalisée sous anesthésie générale. Au moment de la manipulation du deuxième kyste, une augmentation des pressions d’insufflation apparaît, avec des râles sibilants au niveau des deux champs pulmonaires et une désaturation, suivi d’un collapsus vasculaire avec hypotension artérielle 50/30. La prise en charge est débutée aussitôt par un remplissage vasculaire par du sérum salé 9%, suivi par des bolus d’adrénaline de 0,1mg à trois reprises, puis d’une perfusion continue à raison. L’adrénaline est arrêtée au bout de 48 heures et la patiente est adressée au service de chirurgie à j+4 de l’intervention. Le choc anaphylactique est une complication connue de la rupture intra péritonéale spontanée ou post-traumatique du kyste hydatique du foie. Sa survenue en peropératoire est devenue exceptionnelle, grâce aux mesures de prévention chirurgicale entretenues en peropératoire par l’éviction de manipulation du kyste, de le vider avant d’injecter le scolicide, et de ne pas l’administrer sous forte pression.
PédiatrieLicence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
La ponction biopsie rénale (PBR) est un examen indispensable en néphrologie mais à risque de complications graves surtout hémorragique. Nous rapportons l'observation d'un patient âgé de 27 ans ayant bénéficié d'une PBR pour un diagnostic étiologique d'une insuffisance rénale aigue, l’évolution après la biopsie a été marquée par l'installation d'un choc hémorragique d'où la prise en charge en réanimation avec une néphrectomie d'hémostase.
Licence : The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
RésuméObjectifEn Côte d’Ivoire, l’implantation des structures sanitaires pour améliorer l’accessibilité géographique aux soins reste inégale entre milieu rural et urbain. C’est dans ce contexte que l’étudiant en médecine doit se prononcer sur son choix de carrière en tenant également compte de ses préférences personnelles. Le but de notre étude était d’évaluer les aspirations et les facteurs influençant le choix de spécialité des étudiants de la faculté de médecine de l’université Félix Houphouët-Boigny d’Abidjan.MéthodologieLes étudiants en médecine inscrits en 6e année ont rempli un questionnaire anonyme auto-administré. Il s’agissait d’un questionnaire au format papier divisé en 3 parties: critères socio-démographiques; choix de spécialité et facteurs influençant le choix de carrière. Les étudiants étaient invités à évaluer dans quelle mesure ils percevaient chacun des 24 items comme influençant leur choix de carrière au moyen d’une échelle de Likert allant de 1 (aucune influence) à 5 (grande influence). Les facteurs ont été comparés selon le choix de spécialité (médicale ou chirurgicale).RésultatsLes 3 disciplines de spécialité les plus choisies étaient: la cardiologie (17,9 %), la gynéco-obstétrique (15,7 %) et la pédiatrie (9,6 %). Le désir de passer le concours d’internat était plus fréquent chez les étudiants ayant choisi une spécialité chirurgicale (p = 0,02). Le choix d’une spécialité médicale était plus influencé par le désir d’un travail à temps partiel (p = 0,04). Les étudiants ayant choisi une spécialité médicale étaient plus guidés par l’engagement social que ceux ayant choisi une spécialité chirurgicale (p = 0,04). Par contre, ces derniers étaient plus influencés par le prestige auprès des collègues (p = 0,04) et les résultats immédiats après intervention (p = 0,01).ConclusionL’équipement efficient des structures sanitaires pourrait contribuer à une mise en valeur des autres spécialités moins choisies en les rendant plus attractives. Une réorganisati
Médecine interne (cardiologie, endocrinologie, néphrologie…)PédiatrieGynécologie-obstétriqueLicence : https://creativecommons.org/licenses/by/4.0/ Cet article en libre accès est distribué selon les termes de la licence Creative Commons CC BY 4.0 ().
Aimé C. Mwana-wabene, Samuel M. Lwamushi, Christian M. Eboma, Pacifique M-B. Lyab, Bonfils Cheruga, Hermès Karemere, Albert T. Mwembo, Ghislain B. Balaluka, Faustin C. Mukalenge
Therapeutic choices of hypertensive and diabetics in rural areas: A mixed study in two health zones in the East of the Democratic Republic of Congo.BackgroundOne third of patients in the Democratic Republic of Congo (DRC) do not use the formal health system to access healthcare.AimIn this manuscript we analyse the therapeutic decisions of hypertensive and diabetic patients in rural eastern DRC and the reasons for these decisions.SettingThe study was conduct in two health zones (HZ) in South Kivu (Bagira and Walungu), DRC.MethodsA mixed-methods convergent study was conducted from November 2018 to December 2018. Quantitative data were collected using a questionnaire and qualitative data were collected using focus groups. The quantitative data were analysed using descriptive statistics and a Fischer exact test, while the qualitative data were analysed using thematic analysis.ResultsOut of 382 subjects declaring a chronic pathology, hypertensives and diabetics represented 21.5% and 7.9%, respectively. Health facilities were the first therapeutic choice of the chronically affected persons. The alternative therapeutic choices found were the use of prayer rooms, consultation with traditional healers and self-medication. Poverty, ignorance, the pharmaceutical business, and the socio-cultural dimension of the disease are the main causes of alternative therapeutic choices for hypertensives and diabetics.ConclusionTo ensure appropriate care for patients with chronic diseases in rural areas, it is important to establish a bridge of regulated collaboration between the formal and informal health sector.
Médecine interne (cardiologie, endocrinologie, néphrologie…)Licence : Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.