Surgical complications of Pica syndrome: About 3 cases

The Pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a non-nourishing substance which can be relatively harmless, or potentially harmful for the health. It is a rare affection secondary to the accumulation of diverse natured foreign bodies inside the digestive tract and more especially at the stomach level. Gastro-intestinal localization is the most frequent, and can remain asymptomatic for a long time. Treatment is surgical. We report 3 cases of digestive complications of Pica syndrome

Early reoperation in pediatric surgery at the Teaching Hospital Gabriel Touré.

Introduction: To identify complications requiring early reoperation and to determine associated risk factors in the pediatric surgery of the teaching hospital Gabriel Toure.Materials and Methods: A retrospective study of children 0-15 years old during 4 years (January 2014 to December 2017) presenting with a postoperative complication requiring a reoperation and taken care of during the period of study. Observation of bowels or the liquid stools through the opened wound, the presence of air-fluid levels on an abdominal plain X-ray and the absence of resumption of intestinal transit allowed us to make a decision to re-operate.Results: We have re-intervened on 103 patients because of early postoperative complication out of 4730 cases of pediatric surgery carried out in this hospital during these 4 years. This represented 1.54 % of our total surgical activities. The average age of our patients was a 5.2±2.3 year ranging from 2 months to 15 years. The sex ratio was 0.94. Eighty four (81.55 %) of our patients were admitted and operated on emergently. Peritonitis due to digestive system perforation represented 45.28 % of the indications for reoperation followed by the acute intestinal intussusceptions (10.7 %) and traumatic eviscerations (9.7 %). The average duration before the first intervention was 80±13.6mn. The postoperative evisceration was the 1st cause of reoperation followed by the post-operative peritonitis and then post-operative intestinal obstruction. The average time to reoperation was 6.9 ± 4.2 days.Conclusion: In our hospital risk of reoperation has an association with: indication of first surgery, operating technique, experience of the surgeon, malnutrition and anemia (p<0.05). On the other hand sex, age and the duration of surgery have no effect on early reoperation (p > 0.05)

Different Plasmodium falciparum clearance times in two Malian villages following artesunate monotherapy.

BACKGROUND: Artemisinin resistance described as increased parasite clearance time (PCT) is rare in Africa. More sensitive methods such as qPCR might better characterize the clearance phenotype in sub-Saharan Africa. METHODS: PCT is explored in Mali using light microscopy and qPCR after artesunate for uncomplicated malaria. In two villages, patients were followed for 28 days. Blood smears and spots were collected respectively for microscopy and qPCR. Parasitemia slope half-life was calculated after microscopy. Patient residual parasitemia were measured by qPCR. RESULTS: Uncorrected adequate clinical and parasitological responses (ACPR) observed in Faladje and Bougoula-Hameau were 78% and 92%, respectively (p=0.01). This reached 100% for both after molecular correction. Proportions of 24H microscopy positive patients in Faladje and Bougoula-Hameau were 97.2% and 72%, respectively (p<0.0001). Slope half-life was 2.8h in Faladje vs 2H in Bougoula-Hameau (p<0.001) and Proportions of 72H patients with residual parasitemia were 68.5% and 40% in Faladje and Bougoula-Hameau, respectively (p=0.003). The mean residual parasitemia was 2.9 in Faladje vs. 0.008 in Bougoula-Hameau (p=0.002). Although artesunate is efficacious in Mali, the longer parasite clearance time with submicroscopic parasitemia observed may represent early signs of developing P. falciparum resistance to artemisinins

Persistent Submicroscopic Plasmodium falciparum Parasitemia 72 Hours after Treatment with Artemether-Lumefantrine Predicts 42-Day Treatment Failure in Mali and Burkina Faso.

A recent randomized controlled trial, the WANECAM (West African Network for Clinical Trials of Antimalarial Drugs) trial, conducted at seven centers in West Africa, found that artemether-lumefantrine, artesunate-amodiaquine, pyronaridine-artesunate, and dihydroartemisinin-piperaquine all displayed good efficacy. However, artemether-lumefantrine was associated with a shorter interval between clinical episodes than the other regimens. In a further comparison of these therapies, we identified cases of persisting submicroscopic parasitemia by quantitative PCR (qPCR) at 72 h posttreatment among WANECAM participants from 5 sites in Mali and Burkina Faso, and we compared treatment outcomes for this group to those with complete parasite clearance by 72 h. Among 552 evaluable patients, 17.7% had qPCR-detectable parasitemia at 72 h during their first treatment episode. This proportion varied among sites, reflecting differences in malaria transmission intensity, but did not differ among pooled drug treatment groups. However, patients who received artemether-lumefantrine and were qPCR positive at 72 h were significantly more likely to have microscopically detectable recurrent Plasmodium falciparum parasitemia by day 42 than those receiving other regimens and experienced, on average, a shorter interval before the next clinical episode. Haplotypes of pfcrt and pfmdr1 were also evaluated in persisting parasites. These data identify a possible threat to the parasitological efficacy of artemether-lumefantrine in West Africa, over a decade since it was first introduced on a large scale

Reducing Rice Imports in Côte d’Ivoire: Is a Rise in Import Tariff the Solution?

The first-difference version of a source-differentiated almost ideal demand system is used to estimate demand for Ivorian rice imports. The results indicate that Thailand will benefit most from an expansion of imports of luxury rice and broken rice products. Vietnam will gain from growth in the market for standard rice. The results also suggest that adoption of a new 35 percent tariff policy to protect the domestic industry will not be enough to improve social welfare in Côte d’Ivoire in spite of increased production value

Volvulus of the jejunum on cystic lymphangioma: About a clinical case

Intestinal volvulus on mesenteric cysticum lymphangioma (CL) is rare in children. The clinical picture is not very suggestive. We report a case of intestinal volvulus on CL in a 7-year-old girl after an abdominal trauma. Resection and anastomosis were made. The confirmation diagnosis was done by anatomopathological examination. Early diagnosis of intra-abdominal CL will allow avoiding complication