Anesthesie au cours des ventriculocisternostomies au Mali : Une serie de 31 cas

Introduction La ventriculocisternostomie est une technique moderne du traitement des hydrocéphalies. Elle est peu fréquente en Afrique. Objectif:  Décrire la prise en charge anesthésique et l’évolution des patients opérés par ventriculocisternostomie. Patients et Méthode: Etude de cohorte prospective de 15 mois de janvier 2014 au 31 mars 2015. La saisie et l’analyse des données ont été effectuées par Microsoft word 2010 Epi info 3.5.3.fr. Résultats:  Les nourrissons prédominaient avec un sexe ratio de 1,81 en faveur du sexe masculin. Un antécédent de méningite ou d’infection respiratoire à répétition a été retrouvé chez 10 patients (32,2%). L’indication de la ventriculocisternostomie était une hydrocéphalie chez 30 patients (96, 8%). La classe ASA était II chez 19 patients (61,3%). L’intubation était prévue difficile chez 28 patients (90,3%).Tous les patients ont été opérés sous anesthésie générale. Une antibioprophylaxie a été faite chez tous les patients. La tachycardie isolée a été le seul évènement indésirable per opératoire observé chez 13 patients (41,9%). La durée de la chirurgie était de 62, 25 ± 20,9 minutes celle de l’anesthésie était de 93,5 ± 25,4 minutes. En postopératoire, une complication a été observée chez 7 patients (22,6%). Il s’agissait d’une méningite chez 3 patients (42,9%), d’une souffrance cérébrale, d’une obstruction de la stomie, d’un abcès cérébral et une paralysie du nerf III dans 14,3% chacune (1 patient). L’évolution était favorable chez 29 patients (93,5%). La durée médiane d’hospitalisation était de 3 jours. Conclusion:  Au Mali, la prise en charge anesthésique au cours de la ventriculocisternostomie s’adresse à une population pédiatrique avec un terrain précaire.   English title: Anesthesia during endoscopic third ventriculostomy in Mali: A series of 31 cases Introduction: Endoscopic Third Ventriculostomy (ETV) is a modern technique for the treatment of hydrocephalus. It is uncommon in Africa. Objective To describe ananesthesic management and the outcome of patients operated on by ETV. Patients and Methods Prospective cohort study over 15 months to January 2014 at 31 march 2015. The data entry and analysis were done by word office, Epi info 3.5.3.fr. Results: Infants predominated with a sex ratio of 1.81 in favor of men. A history of meningitis or recurrent respiratory infection was found in 10 patients (32.2%). The indication of ETV was hydrocephalus in 30 patients (96.8%). The ASA class was II in 19 patients (61.3%).  Intubation was expected to be difficult in 28 patients (90.3%). All patients were operated on under general anesthesia. Antibiotic  prophylaxis was done in all patients. Isolated tachycardia was the only peroperative adverse event observed in 13 patients (41.9%). The duration of the surgery was 62.25 ± 20.9 minutes that of the anesthesia was 93.5 ± 25.4 minutes. Postoperatively, a complication was observed in 7 patients (22.6%). It was meningitis in 3 patients (42.9%), brain pain, obstruction of the stoma, brain abscess and nerve III paralysis in 14.3% each (1 patient). The outcome was favorable in 29 patients (93.5%). The median hospital stay was 3 days. Conclusion:  In Mali, anesthetic management during ETV is aimed at a pediatric population with precarious terrain

Geographical and temporal distribution of human giardiasis in Ontario, Canada

BACKGROUND: Giardia is the most frequently identified intestinal parasite in North America. Although information on geographical distribution of giardiasis is critical in identifying communities at high risk, little has been done in this area. Therefore, the objective of this study was to investigate the geographical and temporal distribution of human giardiasis in Ontario in order to identify possible high risk areas and seasons. Two spatial scales of analyses and two disease measures were used with a view to identifying the best of each in assessing geographical patterns of giardiasis in Ontario. Global Moran's I and Moran Local Indicators of Spatial Associations were used to test for evidence of global and local spatial clustering, respectively. RESULTS: There were seasonal patterns with summer peaks and a significant (P < 0.001) decreasing temporal trend. Significant (P < 0.05) global spatial clustering of high rates was observed at the Census Sub-division spatial scale but not at the Census Division scale. The Census Sub-division scale was a better scale of analyses but required spatial empirical Bayesian smoothing of the rates. A number of areas with significant local clustering of giardiasis rates were identified. CONCLUSIONS: The study identified spatial and temporal patterns in giardiasis distribution. This information is important in guiding decisions on disease control strategies. The study also showed that there is benefit in performing spatial analyses at more than one spatial scale to assess geographical patterns in disease distribution and that smoothing of disease rates for mapping in small areas enhances visualization of spatial patterns

The estimation of the catchment runoff using a small number of rainfall stations in Burkina Faso

The objective of this study was to determine a suitable method to compute the runoff over a catchment with a few number of rainfall stations. Input hydrological variables were calculated against varying rainfall events duration bounded by at least one no-rainy day. The study shows that it is possible to estimate correctly the runoff over a catchment of about 500 km2, by using the mean rainfall of Thiessen, the antecedent precipitation index and the cumulative rainfall since the start of the rainy season. The accuracy of the method increases when the rainfall stations are uniformly distributed within the catchment. This work must be done by separating the heavy rainfall events (&#8805; 40 mm) into two parts: events of the beginning and events of the middle of the rainy season, in order to indirectly take into account the rainfall intensity. The model was applied to the Mogtedo irrigation scheme (Central region of Burkina Faso). Key Words: Catchment-Rainfall-Runoff-Antecedent precipitation index-Multiple regression. Journal of Environmental Extension Vol.4 2003: 67-7

Chapitre 26. Utilisation des fourrages de céréales-mucuna dans l’alimentation des bœufs de trait

Introduction Dans la zone cotonnière du Mali, l’intensification durable des systèmes de culture et d’élevage passe par l’intégration agriculture-élevage. Le maintien de la fertilité des sols cultivés et l’alimentation des troupeaux posent des problèmes aux agroéleveurs (Coulibaly et al., 2017 a). L’alimentation des animaux en saison sèche est devenue un problème de plus en plus important à la suite de la diminution et de la détérioration des parcours naturels. Cette situation est due aux effe..

The FEAST trial of fluid bolus in African children with severe infection

[No abstract available

ULTRASOUND IN THE ETIOLOGICAL ASSESSMENT OF HEMORRHAGES DURING THE 3RD TRIMESTER OF PREGNANCY AT THE FERTILIA MEDICAL CLINIC IN BAMAKO

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Haemorrhage in the third trimester of pregnancy is a major public health problem because it can jeopardize the vital prognosis of the mother and the fetus. The objective of our study was to study the sonographic etiologies of hemorrhages in the 3rd trimester of pregnancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Subjects and Methods: &lt;/strong&gt;This was a 5-year cross-sectional and prospective study, between JUNE 2017 and MAY 2022, which involved 82 pregnant women who were between 28 and 40 weeks of amenorrhea (SA) and who presented with hemorrhage regardless of its volume. The data collected was obtained on the ultrasound reports and a series of questions asked either of the patient or her companions. Data were entered and analyzed on SPSS version 26.0.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In our study, we performed 12,900 obstetrical ultrasounds, of which 82 women had hemorrhage, i.e. a frequency of 0.63%. The average age was 29 years with extremes ranging from 17 to 43 years. 39 patients or 47.5% were between 20 and 30 years old. 42 patients or 51% were multi gestures. 51 patients or 62% were multiparous. The clinical information prompting an ultrasound was abdominal pain + metrorrhagia in 58.5% of cases. 70.7% were between 37 SA and 42 SA. The sonographic etiologies were retroplacental hematoma (HRP) with 56% placenta previa (33%), placenta previa+HRP (2.2%) and uterine rupture (1.8%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion : &lt;/strong&gt;Faced with the occurrence of metrorrhagia in the 3rd trimester of pregnancy, it is always necessary to think of the most serious etiologies, which are ultimately not so rare and can jeopardize the vital prognosis of the mother and the child. A targeted questioning and a concise clinical examination make it possible to quickly orient towards an etiology. Ultrasound is an invaluable diagnostic and prognostic aid. The speed of emergency care can sometimes save the child, most often the mother.&lt;/p&gt;&lt;p&gt;&nbsp;&lt;/p&gt

Medical-Grade Honey Enhances the Healing of Caesarean Section Wounds and Is Similarly Effective to Antibiotics Combined with Povidone-Iodine in the Prevention of Infections—A Prospective Cohort Study

Caesarean sections (CS) are becoming increasingly popular. The antibiotic resistance crisis and relentless risk of infections, especially in developing countries, demand alternative treatment options. Medical-grade honey (MGH) exerts antimicrobial and healing properties. This study aims to evaluate the effect of MGH treatment on CS wound healing and postoperative complications when compared to conventional treatment (antibiotics in combination with povidone-iodine). In this prospective cohort study, 766 CS patients were included and evenly divided into two groups. The treatment group (n = 383) received an MGH-based formulation (L-Mesitran Soft) and the control group (n = 383) received antibiotics (Amoxicillin) combined with povidone-iodine. The wound healing time and complication rate were determined for both groups, and subsequently, predisposing factors for complications among the baseline characteristics and non-patient-related parameters were determined. The baseline characteristics were similar for both study groups, supporting a homogenous distribution. Postoperative complications were experienced by 19.3% of the patients in the control group and 18.8% in the treatment (MGH) group. The treatment group experienced significantly more superficial pus discharge than the control group, while the latter experienced significantly more deeper pus discharge. BMI, age, duration of hospitalization, anesthesia, and duration of CS could affect the complication risk. MGH significantly enhanced wound healing until day 42. On average, the healing time with MGH was 19.12 ± 7.760 days versus 24.54 ± 8.168 days in the control group. MGH is a potent alternative treatment to antibiotics and povidone-iodine because while the complication risk is similar, MGH has additional benefits. MGH promotes wound healing and does not bear the risk of resistance

Genome-wide genetic variation and molecular surveillance of drug resistance in Plasmodium falciparum isolates from asymptomatic individuals in Ouélessébougou, Mali.

Sequence analysis of Plasmodium falciparum parasites is informative in ensuring sustained success of malaria control programmes. Whole-genome sequencing technologies provide insights into the epidemiology and genome-wide variation of P. falciparum populations and can characterise geographical as well as temporal changes. This is particularly important to monitor the emergence and spread of drug resistant P. falciparum parasites which is threatening malaria control programmes world-wide. Here, we provide a detailed characterisation of genome-wide genetic variation and drug resistance profiles in asymptomatic individuals in South-Western Mali, where malaria transmission is intense and seasonal, and case numbers have recently increased. Samples collected from Ouélessébougou, Mali (2019-2020; n = 87) were sequenced and placed in the context of older Malian (2007-2017; n = 876) and African-wide (n = 711) P. falciparum isolates. Our analysis revealed high multiclonality and low relatedness between isolates, in addition to increased frequencies of molecular markers for sulfadoxine-pyrimethamine and lumefantrine resistance, compared to older Malian isolates. Furthermore, 21 genes under selective pressure were identified, including a transmission-blocking vaccine candidate (pfCelTOS) and an erythrocyte invasion locus (pfdblmsp2). Overall, our work provides the most recent assessment of P. falciparum genetic diversity in Mali, a country with the second highest burden of malaria in West Africa, thereby informing malaria control activities