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

Quality of hydro-alcoholic products used in Senegal: pilot study

Antisepsis and disinfection have always played an important role in the fight against infectious diseases. The use of these products has been effective in breaking the chain of transmission of microorganisms. Today, with the advent of COVID-19, the main recommendations are, among other things, physical distance and the use of antiseptic products, including hydro-alcoholic products. In Senegal, with poor regulations on the acquisition and distribution of antiseptics and disinfectants, this situation has led to a proliferation of antiseptics and disinfectants on the national market. this work aimed to study the quality of hydroalcoholic products found in the trade. We evaluated ten samples of hydro-alcohol products collected during the month of March 2020. Physical and microbiological controls were performed at the National Drug Control Laboratory. The alcohol content of the samples ranged from 63 to 85% and were consistent with WHO recommendations except for samples E3 and E5. The pH values varied between 4.02 and 6.64 and the densities of the hydro-alcoholic gel samples ranged from 0.84 to 0.92 g/cm3; E2, E4, E5, E6 samples had densities greater than 0.89 g/cm3. The samples of hydro-alcoholic products all conformed to the sterility test and no microbiological contamination was observed. Antimicrobial activities of the hydro-alcoholic samples tested ranged from 58.3 to 100% with two samples showing no activity (E2 and E5). In view of the results of this study, it would be relevant to expand and deepen investigations by a significant increase in the number of samples and by carrying out as complete an analysis as possible

Le pneumothorax spontané comme une manifestation évolutive de la polyarthrite rhumatoide: à propos d’une observation clinique et revue de la litterature

La polyarthrite rhumatoïde est une maladie systémique inflammatoire caractérisée par une destruction des synoviales articulaires et des lésions systémiques extra articulaires. Les nodules pulmonaires font partie de ces dernières. Leur évolution peut aboutir à un pneumothorax spontané. Nous rapportons le cas d'un adulte jeune au long passé de polyarthrite rhumatoïde qui a présenté deux épisodes de pneumothorax spontané. Il était admis dans notre service, en urgence, pour un pneumothorax droit spontané et massif sur terrain de polyarthrite rhumatoïde au stade de déformation. Il était sous méthotrexate. La radiographie standard du thorax et la tomodensitométrie montraient un décollement pleural complet droit, des nodules et des images excavées sur les deux champs pulmonaires. Il a bénéficié d'un drainage thoracique aspiratif permettant une bonne ré-expansion pulmonaire. Le pneumothorax spontané constitue une manifestation rare des lésions pulmonaire de la polyarthrite rhumatoïde. Il s'agit le plus souvent d'une manifestation évolutive de la maladie mais aussi une circonstance de découverte de cette dernière. L'implication des immunosuppresseurs reste à être prouvée. Ainsi la polyarthrite rhumatoïde doit être considérée dans la recherche étiologique d'un pneumothorax spontané.Pan African Medical Journal 2015; 2

Filière des produits à usage médicinal issus de Cordyla pinnata, Detarium microcarpum et Detarium senegalense au Sénégal

Abstract The objectives of this study were: 1) to identify and characterize actors involved in products for medicinal use’ value chain of Cordyla pinnata, Detarium microcarpum and Detarium senegalense in Senegal; 2) to analyze the organization of this value chain and the importance of plant parts used; 3) to analyze the commercialization of these products; 4) to identify the strengths, weaknesses, opportunities and threats of the value chain. Snowball sampling was used and allowed to interview, using interviews guides, 13 local healers, 3 harvesters and 17 herbalists. Results showed that actors involved in this value chain collaborated together and benefit from the support of civil society in terms of training and organization. The roots and barks of Cordyla pinnata and Detarium microcarpum were the most widely used while those of Detarium senegalense were poorly commercialized. Barks, roots and leaves were commercialized between 0.11 and 0.29 Euro/100g. Part of the bark was transformed into powder before being marketed among herbalists between 1.05 Euro/100g (for Cordyla pinnata) and 1.52 Euro/100g (Detarium microcarpum). Selling prices were higher in Dakar. Plant parts derived from Cordyla pinnata were mainly used against intestinal parasites while those of Detarium microcarpum and, to a lesser extent, those of Detarium senegalense were used to treat dermatosis. This value chain was faced with weaknesses such as uncontrolled exploitation of the resource and the seasonal scarcity of certain products while long distance from supply sites threatened its good functioning. Key words: products for medicinal use, Cordyla pinnata, Detarium microcarpum, Detarium senegalense, value chain, Senegal.Cette étude avait pour objectifs : 1) d’identifier et de caractériser les acteurs impliqués dans la filière des produits à usage médicinal tirés de Cordyla pinnata, Detarium microcarpum et Detarium senegalense au Sénégal; 2) d’analyser l’organisation de cette filière et l’importance des parties utilisées ; 3) d’analyser la commercialisation de ces produits ; 4) d’identifier les forces, faiblesses, opportunités et menaces de la filière. L’échantillonnage en boule de neige a été utilisé et a permis d’interroger, à l’aide de guides d’entretien 13 tradipraticiens locaux, 3 récolteurs et 17 herboristes. Les résultats ont révélé que les acteurs de cette filière, majoritairement des hommes, entretenaient des relations de coopération et qu’ils bénéficiaient de l’appui de la société civile en termes de formation et d’organisation. Les racines et les écorces de Cordyla pinnata et Detarium microcarpum étaient plus utilisées tandis que celles de Detarium senegalense étaient peu commercialisées. Les écorces, les racines et les feuilles étaient vendues entre 0,11 et 0,29Euro/100g. Une partie des écorces était transformée en poudre avant d’être commercialisée chez les herboristes entre 1,05 Euro/100g (pour Cordyla pinnata) et 1,52 Euro/100g (Detarium microcarpum). Les prix étaient plus élevés à Dakar. Les parties tirées de Cordyla pinnata étaient essentiellement utilisés contre les parasitoses intestinales tandis que celles de Detarium microcarpum et dans une moindre mesure celles de Detarium senegalense servaient à soigner les dermatoses. Les faiblesses de cette filière concernaient essentiellement l’exploitation anarchique de la ressource et la raréfaction saisonnière de certains produits tandis que l’éloignement des sites d’approvisionnement menaçait son bon fonctionnement. Mots clés : produits à usage médicinal, Cordyla pinnata, Detarium microcarpum, Detarium senegalense, filière, Sénégal

Antibiotic susceptibility profile of Streptococcus pneumoniae isolated from acute respiratory infection in Dakar: a cross sectional study

Streptococcus pneumoniae is a pathogen causing pneumonia, meningitis, otitis and bacteraemia. Nowadays, S. pneumoniae is developing antibacterial resistance, particularly for those with reduced susceptibility to penicillin. The objective of this study was to assess the susceptibility profile of S. pneumoniae strains isolated from acute respiratory infections (ARIs) in children younger than 5 years of age in Dakar, Senegal. S. pneumoniae strains were isolated from broncho-alveolar lavages (BALs), nasopharyngeal swabs, and middle ear secretion from children in the Paediatric Department of Abass Ndao University Teaching Hospital and Paediatric Department of Roi Baudouin Hospital in Dakar, Senegal. The strains were cultivated on Columbia agar supplemented with 5% of horse blood and gentamicin (6 mg/L). Antibiotic susceptibility testing was performed using E-test method. A total of 34 strains of S. pneumoniae were isolated and identified in this study, among them 7 strains (20.58%) showed penicillin-resistance. Antibiotics such as amoxicillin/clavulanic acid (MIC90=0.036 μg/mL), cefuroxim (MIC90=0.38 μg/mL), cefixim (MIC90=1.5 μg/mL), as well as macrolides (azithromycin MIC90=1.5 μg/mL, clarithromycin MIC90=0.125 μg/mL) and fluoroquinolone (levofloxacin MIC90=1 μg/mL, ofloxacin MIC90=2 μg/mL) were mostly active. However, all S. pneumoniae strains were resistant to sulfamethoxazole/trimethoprim (MIC90: 32 μg/mL). Except of S. pneumoniae strains penicillin-resistance or reduced susceptibility, most strains were susceptible to β-lactams antibiotics commonly used in ARI treatment. Continuous surveillance of antimicrobial resistance patterns of pneumococcus strains is still crucial for effective control of ARIs in children

Senegal: Presidential elections 2019 - The shining example of democratic transition immersed in muddy power-politics

Whereas Senegal has long been sold as a showcase of democracy in Africa, including peaceful political alternance, things apparently changed fundamentally with the Senegalese presidentials of 2019 that brought new configurations. One of the major issues was political transhumance that has been elevated to the rank of religion in defiance of morality. It threatened political stability and peace. In response, social networks of predominantly young activists, created in 2011 in the aftermath of the Arab Spring focused on grass-roots advocacy with the electorate on good governance and democracy. They proposed a break with a political system that they consider as neo-colonialist. Moreover, Senegal’s justice is frequently accused to be biased, and the servility of the Constitutional Council which is in the first place an electoral court has often been denounced

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Physico-Chemical, Microbiological and Antioxidant Properties of Some Local Honey Samples from Senegal

Honey is one of the most pleasant food substances for humanity. It has many properties and contributes to the improvement of human nutrition. In Senegal, honey is an object of many speculations as for its origin and its physico-chemical and microbiological qualities. In this context, our study aims to evaluate the quality of local honey. Our study focused on six honey samples. Physico-chemical and microbiological analyses were carried out to evaluate the quality of the honey samples. The water content of the honey samples varied from 7.86 to 14.96 %. As for the ash content, the results varied from 0.13 to 0.45 %. The pH of the honey samples varies from 4.60 to 5.05, except for sample E5 which is 6.68. The total acidity values of the honey samples ranged from 10 to 26.5 mEq/kg. The IC50 values for the evaluation of the antiradical activity of the honey samples ranged from 145.05 to 189.40 μg/mL. The honey samples were generally compliant to the microbiological parameters studied, with the exception of samples E2 and E3 for which we had the presence of coliform for both samples and the presence of yeast and mold for sample E2 only.Given the results of this study, it would be necessary to do a more comprehensive study on as many local samples as possible