Mucocèle appendiculaire : A propos de deux observations: Appendicular mucocele: About two observations

The appendix mucocele is a rare pathology, which poses a double problem by its potential malignancy and the risk of peritoneal pseudo-myxoma in case of perforation. The authors report two cases of appendix mucocele in a 61-year-old man and a 58-year-old woman. We found incidentally in imaging an asymptomatic right renal tumor in one observation. La mucocèle appendiculaire est une pathologie rare, qui pose un double problème par sa malignité potentielle et le risque de pseudo-myxome péritonéal en cas de perforation. Les auteurs rapportent deux cas de mucocèle appendiculaire chez un homme de 61 ans et une femme de 58 ans. Il a été retrouvé de manière fortuite en imagerie une tumeur asymptomatique du rein droit dans une observation

Cavernomatose cérébrale sporadique révélée par une crise convulsive: à propos d’un cas

La cavernomatose cérébrale est une pathologie rare pouvant être sporadique ou familiale autosomique dominante. Elle est caractérisée par la présence de cavernomes multiples du système nerveux central. Souvent asymptomatique, la pathologie peut se révéler par des symptômes variés comme l’hémorragie cérébro-méningée, les céphalées ou l’épilepsie. Nous rapportons un cas de cavernomatose cérébrale sporadique chez un patient de 55 ans sans antécédent pathologique particulier révélé par une crise d’épilepsie. A travers cette observation et une revue de la littérature, nous faisons le point sur les aspects cliniques et radiologiques (scanner et IRM) de cette pathologie

Plantes médicinales de l’Afrique de l’Ouest pour la prise en charge des affections respiratoires pouvant se manifester au cours de la Covid-19

Dans le cadre de contribuer à la prise en charge symptomatique des affections respiratoires pouvant se manifester pendant la Covid-19, la présente étude a été entreprise pour recenser les plantes médicinales Africaines actives contre ces manifestations. Une étude bibliographique a été effectuée pour recenser les espèces végétales utilisées dans la prise en charge des maladies respiratoires en Afrique de l’Ouest. La fréquence de citation et un score de convergence d’usage des espèces ont été également calculés. Un total de 318 recettes issues de 145 espèces végétales a été inventorié à travers différentes publications. Guiera senegalensis, Sterculia setigera, Bridelia ferruginea, Euphorbia hirta et Terminalia avicennioides étaient les plantes les plus citées avec les meilleurs scores de convergence d’usage. Les feuilles de ces espèces étaient les plus citées tandis que la toux était la plus indiquée. Les résultats de cette étude pourraient servir de base de données des espèces végétales utilisées dans la prise en charge des maladies du tractus respiratoire en Afrique de l’ouest.Mots clés : Plantes médicinales, Affections respiratoires, Covid-19, Afrique de l’Ouest. English Title: Medicinal plants from West Africa for the management of respiratory diseases that may appear during the Covid-19 As part of contributing to the symptomatic management of respiratory conditions that may manifest during Covid-19, the current study was undertaken to identify African medicinal plants active against these manifestations. A bibliographic study was carried out to identify the plant species used in the management of respiratory diseases in West Africa. The frequency of citation and a convergence score for the use of the species were also calculated. A total of 318 recipes from 145 plant species were inventoried through various publications. Guiera senegalensis, Sterculia setigera, Bridelia ferruginea, Euphorbia hirta and Terminalia avicennioides were the most cited plants with the best usage convergence scores. Leaves from these species were most cited while the cough was more indicated. The results of this study could serve as a database of plant species used in the management of respiratory tract diseases in West Africa.Keywords: Medicinal plants, Respiratory Affections, Covid-19, West Africa

Indications et résultats de la chirurgie de résection des bulles d’emphysème pulmonaire

La chirurgie d'exérèse des bulles ou bullectomie, principal moyen thérapeutique dans la prise en charge des bulles d'emphysème pulmonaire, est généralement réservée aux patients dont les bulles sont compliquées ou, sont à l'origine d'une dyspnée invalidante. Le but de notre étude était de déterminer les indications de la bullectomie et d'évaluer les résultats de cette chirurgie dans notre service. Nous avons mené une étude rétrospective descriptive de 24 patients (23 hommes et 1 femme), dont la moyenne d'âge était de 49 ans, et qui ont bénéficié d'une bullectomie entre 2004 et 2013. Les données recueillies étaient les facteurs favorisant la survenue d'un emphysème bulleux, les circonstances de découverte de la bulle, les données des examens radiologiques, les données de l'évaluation fonctionnelle respiratoire et cardiovasculaire, les données de la technique de la bullectomie, les données de l'évaluation clinique et fonctionnelle post opératoire. Le taux de morbidité était de 37,5%. La principale complication était la fuite aérienne persistante (7 cas). Un patient est décédé au 2e jour post opératoire suite à une insuffisance respiratoire aiguë. La durée moyenne de suivi était de 26 mois. Durant ce suivi, nous avons observé une amélioration de la dyspnée chez tous les patients et nous n'avons noté aucune complication. La bullectomie est une technique chirurgicale efficace, fiable et sûre qui peut permettre aux patients d'avoir une meilleure qualité de vie pendant quelques années

Contrôle Physicochimique des Feuilles de Lippia chevalieri Moldenke Cultivé

Au Mali, le Malarial 5 qui est un Médicament Traditionnel Amélioré (MTA) produit en partie à base de feuilles de Lippia chevalieri est utilisé pour traiter les symptômes du paludisme simple. Les feuilles de Lippia chevalieri cultivé peuvent être utilisées pour la préparation des MTA lorsqu’elles sont de qualité. La présente étude portée sur le contrôle physicochimique a montré que les feuilles de Lippia chevalieri cultivé ont des teneurs en eau inférieures à 10%, celles des cendres totales un peu élevées et celles des cendres insolubles dans l’acide chlorhydriques à 10% faibles. Les meilleurs rendements des extractions sont obtenus par l’eau par infusion et par décoction. Plusieurs groupes chimiques comprenant entre autres des caroténoïdes, des coumarines, des mucilages, des flavonoïdes ont été révélés. In Mali, Malarial 5, which is an Improved Traditional Medicine (ITM) produced partly from the leaves of Lippia chevalieri, is used to treat the symptoms of uncomplicated malaria. The leaves of cultivated Lippia chevalieri can be used for the preparation of improved traditional medicines because they are of good quality. This paper focuses on the physicochemical control which showsthat the leaves of cultivated Lippia chevalieri contain less than 10% of moisture content. The total ash content was a little higher, and the acid insoluble ash was low. The best yields of extractions are obtained with water through infusion and decoction. Several chemical compounds including carotenoids, coumarins, mucilage, and flavonoids were revealed

Operational Issues and Trends Associated with the Pilot Introduction of Zinc for Childhood Diarrhoea in Bougouni District, Mali

Zinc for the treatment of childhood diarrhoea was introduced in a pilot area in southern Mali to prepare for a cluster-randomized effectiveness study and to inform policies on how to best introduce and promote zinc at the community level. Dispersible zinc tablets in 14-tablet blister packs were provided through community health centres and drug kits managed by community health workers (CHWs) in two health zones in Bougouni district, Mali. Village meetings and individual counselling provided by CHWs and head nurses at health centres were the principal channels of communication. A combination of methods were employed to (a) detect problems in communication about the benefits of zinc and its mode of administration; (b) identify and resolve obstacles to implementation of zinc through existing health services; and (c) describe household-level constraints to the adoption of appropriate home-management practices for diarrhoea, including administration of both zinc and oral rehydration solution (ORS). Population-based household surveys with caretakers of children sick in the previous two weeks were carried out before and four months after the introduction of zinc supplementation. Household follow-up visits with children receiving zinc from the health centres and CHWs were conducted on day 3 and 14 after treatment for a subsample of children. A qualitative process evaluation also was conducted to investigate operational issues. Preliminary evidence from this study suggests that the introduction of zinc does not reduce the use of ORS and may reduce inappropriate antibiotic use for childhood diarrhoea. Financial access to treatments, management of concurrent diarrhoea and fever, and high use of unauthorized drug vendors were identified as factors affecting the effectiveness of the intervention in this setting. The introduction of zinc, if not appropriately integrated with other disease-control strategies, has the potential to decrease the appropriate presumptive treatment of childhood malaria in children with diarrhoea and fever in malaria-endemic areas

Operational Issues and Trends Associated with the Pilot Introduction of Zinc for Childhood Diarrhoea in Bougouni District, Mali

Zinc for the treatment of childhood diarrhoea was introduced in a pilot area in southern Mali to prepare for a cluster-randomized effectiveness study and to inform policies on how to best introduce and promote zinc at the community level. Dispersible zinc tablets in 14-tablet blister packs were provided through community health centres and drug kits managed by community health workers (CHWs) in two health zones in Bougouni district, Mali. Village meetings and individual counselling provided by CHWs and head nurses at health centres were the principal channels of communication. A combination of methods were employed to (a) detect problems in communication about the benefits of zinc and its mode of administration; (b) identify and resolve obstacles to implementation of zinc through existing health services; and (c) describe household-level constraints to the adoption of appropriate home-management practices for diarrhoea, including administration of both zinc and oral rehydration solution (ORS). Population-based household surveys with caretakers of children sick in the previous two weeks were carried out before and four months after the introduction of zinc supplementation. Household follow-up visits with children receiving zinc from the health centres and CHWs were conducted on day 3 and 14 after treatment for a subsample of children. A qualitative process evaluation also was conducted to investigate operational issues. Preliminary evidence from this study suggests that the introduction of zinc does not reduce the use of ORS and may reduce inappropriate antibiotic use for childhood diarrhoea. Financial access to treatments, management of concurrent diarrhoea and fever, and high use of unauthorized drug vendors were identified as factors affecting the effectiveness of the intervention in this setting. The introduction of zinc, if not appropriately integrated with other disease-control strategies, has the potential to decrease the appropriate presumptive treatment of childhood malaria in children with diarrhoea and fever in malaria-endemic areas

Brucellosis in dairy herds: a public health concern in the milk supply chains of West and Central Africa

Ten herd-level cross-sectional studies were conducted in peri-urban dairy production areas of seven West and Central African countries (Burkina Faso, Burundi, Cameroon, Mali, Niger, Senegal and Togo). The objectives were to estimate herd level Brucella spp. seroprevalence and identify risk factors for seropositivity. In each of the ten study areas, herds (between 52 and 142 per area, total = 965) were selected probabilistically and a structured questionnaire was administered to gather information on their structure and management. A bulk milk sample from each herd was tested by indirect ELISA for Brucella spp. For each area, herd seroprevalence estimates were obtained after adjusting for the assumed performance of the diagnostic test. Herd level risk factors for Brucella spp. seropositivity were identified by means of stratified logistic regression, with each peri-urban zone as a stratum. Area-specific models were also explored. Estimated herd seroprevalences were: Lomé (Togo) 62.0% (95% CI:55.0-69.0), Bamako (Mali) 32.5% (95% CI:28.0-37.0), Bujumbura (Burundi) 14.7% (95%CI:9.4-20.8), Bamenda (Cameroon) 12.6% (95% CI:7.6-21.9), Ouagadougou (Burkina Faso) 3.0% (95% CI:1.0-9.1), Ngaoundere (Cameroon) 2.3% (95% CI:1.0-7.0), Thies (Senegal) 1.3% (95% CI:0.1, 5.3), Niamey (Niger) 1.2% (95% CI:0.08-5.3), Dakar (Senegal) 0.2% (95% CI:0.01-1.7) and Niakhar (Senegal) <0.04%. Logistic regression modelling revealed transhumant herds to be at lower risk of infection (adjusted OR: 0.25, 95% CI: 0.13 - 0.5) and in one of the areas (Bamenda), regular purchase of new animals was found to be strongly associated with Brucella spp. seropositivity (adjusted OR = 5.3, 95% CI: 1.4-25.9). Our findings confirm that Brucella spp. circulates among dairy cattle supplying milk to urban consumers in West and Central Africa, posing a serious public health concern. Control programs are urgently needed in areas such as Lomé or Bamako, where more than 30% of the herds show evidence of infection