Luxation sous-astragalienne fermée et isolée. Cas clinique et revue de la littérature.

La luxation totale sous astragalienne sans fracture des malléoles, entité clinique rare, est généralement due à un mécanisme traumatique de haute énergie. Nous présentons le cas d’une femme de 40 ans, victime d’un accident de la voie publique, traitée orthopédiquement avec succès. La prise en charge de cette lésion traumatique est discutée à la lumière de la littérature.Mots-clés : accident de décélération, luxation astragale, traitement orthopédique

Managing neurocysticercosis: challenges and solutions

Yannick Fogoum Fogang, Abdoul Aziz Savadogo, Massaman Camara, Dènahin Hinnoutondji Toffa, Anna Basse, Adjaratou Djeynabou Sow, Mouhamadou Mansour Ndiaye Neurology Department, Fann Teaching Hospital, Cheikh Anta Diop University, Dakar, Senegal Abstract: Taenia solium neurocysticercosis (NCC) is a major cause of neurological morbidity in the world. Variability in the neuropathology and clinical presentation of NCC often make it difficult to diagnose and manage. Diagnosis of NCC can be challenging especially in endemic and resource-limited countries where laboratory and imaging techniques are often lacking. NCC management can also be challenging as current treatment options are limited and involve symptomatic agents, antiparasitic agents, or surgery. Although antiparasitic treatment probably reduces the number of active lesions and long-term seizure frequency, its efficacy is limited and strategies to improve treatment regimens are warranted. Treatment decisions should be individualized in relation to the type of NCC. Initial measures should focus on symptomatic management, with antiparasitic therapy only to be considered later on, when appropriate. Symptomatic treatment remains the cornerstone in NCC management which should not only focuses on epilepsy, but also on other manifestations that cause considerable burden (recurrent headaches, cognitive decline). Accurate patients' categorization, better antiparasitic regimens, and definition of new clinical outcomes for trials on NCC could improve management quality and prognosis of NCC. Prevention strategies targeting tapeworm carriers and infected pigs are yielding good results in local models. If local elimination of transmission is confirmed and replicated, this will open the door to cysticercosis eradication efforts worldwide. Keywords: neurocysticercosis, Taenia solium, epilepsy, headache, albendazole, praziquante

Analysis and clinical correlates of 20 Hz photic driving on routine EEG in migraine.

Enhanced photic driving (PD) during high-frequency flicker stimulation, the so-called H response, is a classical feature of migraine patients between attacks, but is thought to be of poor clinical utility. Visual inspection of the EEG for its detection may not be reliable, however, data on its possible correlations with clinical features and migraine pathophysiology are scarce. We have compared visual inspection and EEG spectral analysis to detect abnormal PD in 280 consecutive migraine patients of our headache clinic (episodic migraine without aura, n = 171; chronic migraine, n = 48; migraine with aura, n = 61) and in a group of 24 non-migrainous neurological controls. Spectral frequency analyses were performed blindly by one of us (YF). On visual inspection, 50.4 % of migraineurs were thought to have increased 20 Hz PD. After spectral analysis, only 62.4 % of them had PD power superior to the mean + 95 % CI of the control group. Sensitivity of visually identified PD was 82.24 %, specificity 69.36 %. Increased PD on spectral analysis was more prevalent in episodic migraine than in chronic migraine, in patients with low attack frequency, in those with ictal autonomic symptoms in addition to nausea and in those with a strong family history of migraine. We confirm therefore that 20 Hz photic driving is of little diagnostic utility and its prevalence in migraine overestimated on visual inspection. Its presence on spectral analysis of the EEG, however, might be of pathophysiological interest, as it identifies subgroups of migraineurs of whom the common denominator could be lack of habituation of cortical responses during repetitive stimulation

L'attention selective en periode non douloureuse des etudiants souffrant de cephalees primaires: Une etude cas-temoins

Background: Headache patients frequently complain about difficulties in attention and concentration, even when they are headache-free and psychometric studies concerning attentional deficits in headache patients between attacks are scarce. Objective: To evaluate selective attention of headache patients in a pain free period and compare them with healthy volunteers. Subjects and Methods: We performed, between February 2011 and July 2011, a case-control study, including 45 university students consulting for primary headaches, matched with 45 healthy students as controls. Headaches were classified according to the International Headache Society criteria (IHS, 2004). Subjects with a history of brain injury, epilepsy and visual disturbancies were excluded. Mood disorders were assessed using the Hospital Anxiety Depression (HAD) questionnaire. Selective attention was evaluated using the D-KEFS color-word interference test. Results: Mean age of patients was 23.29 ± 2.55 years, versus 22.89 ± 2.04 years for controls (p = 0.2). Migraine and tension-type headaches were the only diagnosed headache types, respectively 55.56% and 44.44%. The selective attention score was -4.04 ± 7.08 for patients, versus -1.31 ± 7.73 for controls (p = 0.02). The mean mental flexibility score was lower in headache sufferers compared to controls (36.67 ± 6.79 versus 41.33 ± 6.23, p = 0.001). Gender, anxiety and depression scores, and temporal features of headache had no correlation with selective attention score. Conclusion: Selective attention and mental flexibility capacities seem to be reduced in primary headache sufferers in pain free period. These findings could contribute to our understanding of the pathophysiology of primary headaches.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Traditional herbal remedies and dietary spices from Cameroon as novel sources of larvicides against filariasis mosquitoes?

In Cameroon, many dietary spices are used by traditional healers to cure several diseases such as cancer and microbial infections. Aframomum daniellii, Dichrostachys cinerea and Echinops giganteus are Cameroonian spices widely used as flavourings and as food additives. Moreover, they are traditionally herbal remedies employed to treat several diseases, as well as to control populations of insect pests. In this research, we analysed the chemical composition of A. daniellii, D. cinerea and E. giganteus essential oils and we evaluated their larvicidal potential against larvae of the filariasis and West Nile virus vector Culex quinquefasciatus. The essential oils were obtained from different plant parts by hydrodistillation and their composition was analysed by GCMS. The three spices exhibited different volatile chemical profiles, being characterized by 1,8-cineole, sabinene and β-pinene (A. daniellii), geraniol and terpinen-4-ol (D. cinerea), and silphiperfol-6-ene and presilphiperfolan-8-ol (E. giganteus). Results showed that the highest larvicidal toxicity on Cx. quinquefasciatus was exerted by D. cinerea essential oil (LC50 = 39.1 μL L−1), followed by A. daniellii (pericarp essential oil: LC50 = 65.5 μL L−1; leaves: LC50 = 65.5μL L−1; seeds: LC50 = 106.5μL L−1) and E. giganteus (LC50 = 227.4 μL L−1). Overall, the chance to use the D. cinerea essential oil against Cx. quinquefasciatus young instars seems promising, since it is effective at moderate doses and could be an advantageous alternative to build newer mosquito control tools

Characterization and biological activity of essential oils from fruits of Zanthoxylum xanthoxyloides Lam. and Z. leprieurii Guill. & Perr., two culinary plants from Cameroon

Essential oils obtained by hydrodistillation of dried fruits of Zanthoxylum xanthoxyloides and Z. leprieurii (Rutaceae), were analysed by gas chromagraphy–flame ionization detection and gas chromatography–mass spectrometry. In the former, the major volatiles resulted citronellol (29.9%) and geraniol (11.5%), followed by citronellyl acetate (5.5%), limonene (5.5%) and citronellal (4.6%), while in the latter the major compounds were (E)-b-ocimene (29.4%), myrcene (28.6%), limonene (13.6%) and a-pinene (8.1%), respectively. The chemical composition supports the traditional use of these plants as spices in local food. The oils were also tested for antiproliferative, antimicrobial and antioxidant activities by MTT assay, agar disc diffusion method, and DPPH, ABTS and b-carotene–linoleic acid assay, respectively. The noteworthy cytotoxic effects of Z. xanthoxyloides are probably related to the presence of geraniol and citronellol, which exhibited strong antiproliferative activity against all the tested human tumor cell lines, and support the local traditional use of this plant for the treatment of various cancers

Antioxidant, Antiproliferative and Antimicrobial Activities of the Volatile Oil from the Wild Pepper Piper capense Used in Cameroon as a Culinary Spice

Wild pepper (Piper capense L.f., Piperaceae) is a spice traditionally used in western Cameroon to make soups called ‘Nkui’ and ‘Nah poh’. In the present work, the essential oil hydrodistilled from fruits was analyzed by GC-FID and GC-MS, and for in vitro biological activities, namely cytotoxic, antioxidant and antimicrobial, by MTT, DPPH, ABTS and agar disc diffusion methods. The oil composition was dominated by monoterpene hydrocarbons (56.5%) responsible for the pepper odor, such as β-pinene (33.2%), sabinene (10.0%) and α-pinene (8.9%). The oil induced a concentration-dependent inhibitory effect on human tumor cells MDA-MB 231 (breast adenocarcinoma), A375 (malignant melanoma) and HCT116 (colon carcinoma), showing IC50 values of 26.3, 76.0 and 22.7 μg/ml, respectively. The oil showed total antioxidant activity with a Trolox equivalent antioxidant concentration (TEAC) value of 140 µmol/g. The essential oil of P. capense proved to be an effective scavenger of the ABTS+ radical, with an activity only about 30 times lower than that of Trolox. Moderate activity was observed against the Gram-positive species Staphylococcos aureus and Enterococcus faecalis, and the yeast Candida albicans. The notable inhibition of some human tumor cells is worthy of further investigation to discover the possible mechanisms of action responsible for the observed cytotoxic effect of this essential oil