Congenital insensitivity to pain with anhydrosis: report of a family case

Congenital Insensitivity to pain with anhydrosis (CIPA) is a rare inherited disease. It is classified as hereditary sensory and autonomic neuropathy type IV. Pain insensitivity and autonomic deficits are present, but touch and pressure sensitivity are unimpaired. Mental retardation is usually present. We report a family case of a 5 years old girl and 2 years old boy with congenital insensitivity to pain, while discussing the clinical features and the anesthetic strategy of such patients. Patients with Congenital Insensitivity to Pain with anhydrosis may undergo surgery because of susceptibility to trauma due to absence of pain. The clinical features may intrinsically possess anesthetic challenges

Sidération myocardique au cours d’une intoxication au monoxyde de carbone (CO) chez une femme enceinte

L'intoxication au monoxyde de carbone (CO) est la première cause de décès par intoxication en France. La littérature est ancienne et peu connue. Les signes les plus fréquents de l'intoxication sont la triade: Céphalées; asthénie, faiblesse musculaire surtout des membres inférieurs. Ses conséquences sont potentiellement graves pour le foetus quand elle survient chez la femme enceinte, il est particulièrement exposé au risque d'hypoxie en raison de la forte affinité de son hémoglobine pour le CO qui traverse aisément le placenta. Les événements cardiovasculaires ne sont pas rares et peuvent être responsable d'une morbi-mortalité assez importante qui peuvent être d'apparition rapide ou secondaire mais régressent habituellement en quelques jours. Des SCA peuvent survenir lors d'une une intoxication au CO avec à l'extrême infarctus myocardique avec surélévation du segment ST. Il paraît légitime de proposer pour toutes les patientes: l'éloignement maternel de la source de CO; l'oxygénothérapie à 100% au masque facial par les services de secours et pendant le transfert; le traitement par oxygénothérapie hyperbare pour toutes les femmes enceintes, le plus rapidement possible et quelque soit l'âge gestationnel.Pan African Medical Journal 2015; 2

Atropa Belladonna intoxication: a case report

Atropa Belladonna is a poisonous plant also called deadly nightshade. Its roots, leaves and fruits contain alkaloids: atropine, hyocyamine and scopolamine. The risk of poisoning in children is important because of possible confusion with other berries. Atropa Belladonna acute intoxication is a severe condition, it's should be considered in the presence of anti-cholinergic toxidrome, the differential diagnosis include other plants or psychoactive drugs containing atropine. The treatment is mainly symptomatic including gastrointestinal decontamination with activated charcoal. In severe cases, physostigmine can be used as an antidote. We report the case of 11 year old girl with Atropa Belladonna poisoning which was administrated in a therapeutic purpose as a remedy to jaundice. The child presented essentially a central anti-cholinergic syndrome. She was admitted in the intensive care unit, the progression was favorable with symptomatic treatment

Piqures massives par un essaim d'abeilles chez un enfant

Les piqûres multiples d'abeilles sont responsables d'envenimation sévère. Nous rapportons un cas d'une attaque massive par un essaim d'abeilles chez un enfant de sept ans. Sa gravité est liée à la localisation céphalique et au nombre important des piqûres qui était d'environ 270. Ses complications étaient l'insuffisance rénale, l'anémie et une conjonctivite. La prise en charge était symptomatique avec bonne évolution clinique et biologique

Envenimation mortelle par morsure de serpent chez une femme enceinte

En Afrique, la prise en charge des envenimations vipérines demeure un problème majeur de santé publique avec un taux de mortalité qui reste élevé.La survenue d’une envenimation vipérine au cours de la grossesse est un événement rare, et grave du fait des conséquences maternelles et fatales qui en découlent. Les auteurs rapportent un cas de morsure de serpent au niveau de la face chez une femme enceinte, dont l’évolution a été marquée par l’installation d’un œdème cervico-facial nécessitant une trachéotomie en urgence, et une mort fatale in utero avec troubles de l’hémostase responsable du décès maternel dans un tableau de choc hémorragique

Contribution a l'etude des phenomenes de conduction dans les photoresistances en AsGa : application a la conception d'un photodetecteur de gain eleve

SIGLET 54986 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc

Wernicke’s Encephalopathy Complicating Hyperemesis during Pregnancy

Wernicke’s encephalopathy is caused by severe thiamine deficiency; it is mostly observed in alcoholic patients. We report the case of a 28-year-old woman, at 17 weeks of gestational age, with severe hyperemesis gravidarum. She presented with disturbance of consciousness, nystagmus, ophthalmoplegia, and ataxia. The resonance magnetic imagery showed bilaterally symmetrical hyperintensities of thalamus and periaqueductal area. The case was managed with very large doses of thiamine. The diagnosis of Wernicke’s encephalopathy was confirmed later by a low thiamine serum level. The patient was discharged home on day 46 with mild ataxia and persistent nystagmus. Wernicke’s encephalopathy is a rare complication of hyperemesis gravidarum. It should be diagnosed as early as possible to prevent long-term neurological sequela or death. Thiamine supplementation in pregnant women with prolonged vomiting should be initiated, especially before parenteral dextrose infusion. Early thiamine replacement will reduce maternal morbidity and fetal loss rate

Prolonged neuromuscular block in a preeclamptic patient induced by magnesium sulfate

Recent large use of magnesium in the obstetric population should incite anesthesiologists to control its side effects and drugs interactions. We report a case of a 30-year-old woman, with severe preeclampsia and HELLP syndrome, receiving sulfate magnesium and nicardipine, who underwent a cesarean section under general anesthesia. She developed a prolonged and deep neuromuscular blockade, which was antagonized three hours later with neostigmine. In case of therapeutic hypermagnesaemia, non-depolarizing relaxants must be used in reduced doses, and at increased time intervals, with appropriate neuromuscular monitoring.The Pan African Medical Journal 2016;2

Peganum harmala L. Intoxication in a Pregnant Woman

Peganum harmala L. is a plant widely distributed in the Mediterranean region. It is commonly used in traditional medicine in Morocco as sedative and abortifacient but exposes users to the risk of overdose and poisoning. The pharmacologically active compounds of this plant include a number of β-carboline and quinazoline alkaloids responsible of its pharmacological and toxicological effects. We report the case of a 24-year-old woman, 22 weeks pregnant, intoxicated with the seeds of Peganum harmala L. On admission, she had disturbance of consciousness, uterine contraction, and oliguria. Laboratory tests revealed renal failure and liver injury, and she benefited then from hemodialysis. During hospitalization, she was intubated after deterioration of consciousness and presented a spontaneous expulsion of the fetus. After extubation, she kept unusual sequelae: cerebellar ataxia and peripheral polyneuropathy. Physicians in regions using Peganum harmala L. as traditional medicine must be able to detect symptoms of its toxicity, in order to establish early gastrointestinal decontamination. The prognosis of this intoxication is variable; most cases can be managed successfully; but in high doses of intoxication, evolution can be fatal