Brachial plexus lesions: Anatomical knowledge as an essential diagnostic tool in a situation of limited imaging facilities

Diagnosing brachial plexus lesion is a challenge in countries where imaging facilities are not well developed. Here we report 3 cases of different lesions of the brachial plexus sustained after a road traffic crush. The first case presented with a lesion of the 3 primary trunks of the right brachial plexus. The clinical examination showed paralysis of all terminal nerves of the brachial plexus and the collateral branches of both anterior and posterior brachial plexus. The second patient showed paralysis of all muscles of the shoulder and muscles of the anterior compartment of the arm. This clinical feature is in accordance of the upper brachial trunk lesion. The third patient had paralysis of muscles of the hand being innerved by median nerve or ulna nerve. He showed also paralysis of muscles of the anterior compartment of the forearm and anaesthesia of the medial region of hand and forearm. This clinical feature was in conformity with a lesion of inferior primary trunk. All diagnoses were made based on the clinical findings. These cases demonstrate the significance of a through anatomical knowledge in the clinical examination if one has to avoid confusing the signs of terminal nerves lesion with the trunk’s lesion. These cases underscore the importance of applied anatomy in clinical situations

Poland’s Syndrome: A case report

Poland’s Syndrome is a rare congenital condition. It is classically characterized by absence of unilateral chest wall muscles and sometimes ipsilateral symbrachydactyly (abnormally short and webbed fingers). The condition typically presents with unilateral absence of the sternal or breastbone portion of the pectoralis major muscle which may or may not be associated with the absence of nearby musculoskeletal structures. We report a 12-year-old boy patient with typical features of Poland syndrome. To the best of our knowledge, this is the first documented case of a patient with Poland syndrome reported from Rwanda

Contribution à l'étude des caspases au cours de l'apoptose physiologique et induite par l'acide rétinoïque et l'irradiation lors du développement crânio-facial précoce: corrélation avec la protéine HSP110

Doctorat en Sciences médicalesinfo:eu-repo/semantics/nonPublishe

An Unusual Case Of Conjoined Twins

Conjoined twins are not a usual anomaly seen at birth and certainly people may have different or wrong beliefs about this malformation especially when seen for the first time. In this article, we review some important cases of conjoined twins in the history and we present a very rare case of parapagus united twins after an overview of literature. We will end up with a short discussion and conclusion.Les jumeaux siamois ne sont pas une anomalie habituellement constatée à la naissance et ils peuvent susciter des convictions différentes ou erronées à des gens différents, surtout lorsque vus pour la première fois. Dans cet article on passe en revue quelques cas intéressants de jumeaux conjoints décrits dans l’histoire, la littérature et on presente un cas très rare de jumeaux conjoints parapagus. On terminera par une brève discussion et conclusion

Prune-Belly Syndrome: A Case Report from Rwanda

Background: Prune-Belly syndrome, Eagle-Barret syndrome and triad syndrome, all refer to congenital anomalies involving abdominal musculature, urinary tract and testicles. The syndrome consists of a triad of abdominal muscle aplasia, massive ureteral and bladder dilatation and cryptorchidism. Kidneys are often affected by secondary hydronephrosis or by polycystic dysplasia. The full manifestation of the syndrome occurs almost exclusively in boys. Available reports on the epidemiology and outcome show a high perinatal mortality due to related prematurity and associated pulmonary complications. The management of a prune-belly patient has been controversial. However nowadays, the tendency is to assist primarily prune – belly neonates in respiratory failure, and to limit radical urologic interventions. Case Report: We report hereby a full term prune-belly neonate who succumbed from this condition before being adequately investigated. Our purpose is to call clinicians’ attention to early recognition, investigation and management of the syndrome. Even though infants with a full-blown syndrome have a poor prognosis for long term survival, all patients need careful evaluation and individualized management according to the spectrum of the syndrome. In this paper, the morphogenesis and the developmental biology of the abdominal wall will be also recalled, and literature reviewed

Brachial Plexus Lesions: Anatomical Knowledge as an Essential Diagnostic Tool in a Situation of Limited Imaging Facilities

Diagnosing brachial plexus lesion is a challenge in countries where imaging facilities are not well developed. Here we report 3 cases of different lesions of the brachial plexus sustained after a road traffic crush. The first case presented with a lesion of the 3 primary trunks of the right brachial plexus. The clinical examination showed paralysis of all terminal nerves of the brachial plexus and the collateral branches of both anterior and posterior brachial plexus. The second patient showed paralysis of all muscles of the shoulder and muscles of the anterior compartment of the arm. This clinical feature is in accordance of the upper brachial trunk lesion. The third patient had paralysis of muscles of the hand being innerved by median nerve or ulna nerve. He showed also paralysis of muscles of the anterior compartment of the forearm and anaesthesia of the medial region of hand and forearm. This clinical feature was in conformity with a lesion of inferior primary trunk. All diagnoses were made based on the clinical findings. These cases demonstrate the significance of a through anatomical knowledge in the clinical examination if one has to avoid confusing the signs of terminal nerves lesion with the trunk's lesion. These cases underscore the importance of applied anatomy in clinical situations

Poland’s Syndrome: A Case Report

Poland’s Syndrome is a rare congenital condition. It is classically characterized by absence of unilateral chest wall muscles and sometimes ipsilateral symbrachydactyly (abnormally short and webbed fingers). The condition typically presents with unilateral absence of the sternal or breastbone portion of the pectoralis major muscle which may or may not be associated with the absence of nearby musculoskeletal structures. We report a 12-year-old boy patient with typical features of Poland syndrome. To the best of our knowledge, this is the first documented case of a patient with Poland syndrome reported from Rwanda

Clinical And Genetic Diagnosis Of Multiple Osteochondromas In Rwandan Patients

Multiple Osteochondromas (MO) or hereditary multiple exostoses (HME) is an autosomal dominant skeletal disorder mainly characterized by multiple osteochondromas predominantly located at the growth plates of long bones. MO is a genetically heterogeneous disorder and results from mutations in EXT1 and EXT2 genes located on chromosome 8q23-q24 and 11p11-p12. We hereby report a case of a 23-year-old girl who presented characteristic clinical and radiological features of MO. The same clinical signs were observed in her relatives. The p.Arg340Cys mutation in the EXT1 gene was found in the proband confirming the clinical diagnosis. A surgical management was carried out in all affected bones which consisted of excision of the bigger and pain full osteochondromas. The patient was informed of her problem and genetic counseling was offered to the family’s members.La maladie des exostoses multiples ou ostéochondromes multiples est maladie osseuse d’origine génétique autosomique dominante principalement caractérisée par la présence de plusieurs excroissances osseuses qui se présentent comme des bosses prédominant au niveau de l’extrémite des os longs. L’exostose multiple est une maladie génétiquement hétérogene pouvant résulter des altérations (mutations) de plusieurs gènes dont les plus fréquents sont les gènes EXT1 et EXT2 localisés sur les chromosomes 8q23-q24 et 11p11-p12, respectivement. Ici nous présentons un cas d’une jeune fille âgée de 23 ans qui présentait des signes cliniques et radiologiques caractéristiques d’exostoses multiples. Le même phénotype a été observé chez certains membres de sa famille. Une mutation p.Arg340Cys a été identifiée chez cette patiente confirmant le diagnostic. Une prise en charge chirurgicale a été entreprise et consistant à enlever les excroissances osseuses grosses et qui entrainaient la douleur chez la patiente. En plus, toutes les informations concernant la maladies ont été donnees à la patiente et un conseil génétique a été donné aux autres membres de la famille

HSP110, caspase-3 and -9 expression in physiological apoptosis and apoptosis induced by in vivo embryonic exposition to all-trans retinoic acid or irradiation during early mouse eye development

Apoptosis is an essential physiological process in embryonic development. In the developing eye of vertebrates, three periods of developmental apoptosis can be distinguished: early, intermediate and later. Within the apoptosis pathway, caspases play a crucial role. It has also been shown that HSP110 may have a potential role in apoptosis. The aim of this research was to study the expression of HSP110, caspase-3 and -9 in physiological, retinoic- or irradiation-induced apoptosis during early eye development. Seven pregnant C57Bl/6J mice received 80 mg kg−1 of all-trans retinoic acid mixed with sesame oil. Seven pregnant NMRI mice received 2 Gy irradiation at the same gestational day. Control mice of both strains (seven mice of each) were not submitted to any treatment. Embryos were harvested at 3, 6, 12 and 24 h after exposition, fixed, dehydrated and embedded. Coronal sections (5 µm) were made. Slide staining occurred alternatively using anti-caspase-3, anti-caspase-9 and anti-HSP110 immunohistochemistry. HSP110 and caspase-3 expression presented similar topographic and chronological patterns, whereas expression of HSP110 was more precocious in retinoic acid-treated embryos. After retinoic exposure, caspase-3- and HSP110-positive cells were increased in the region of the optic vesicle. By contrast, after irradiation, caspase-3- and HSP110-positive cells were noticeably increased in the optic vesicle, peri-optical mesoderm but less in lens placode. HSP110 was expressed before caspase-3. By contrast, caspase-9 was expressed by a very small number of cells in the optic vesicle either under physiological or under teratogenic conditions. Thus, it seems that activation of caspase-9 is dispensable in early eye developmental apoptosis.info:eu-repo/semantics/publishe

Successful surgical separation of conjoined twins: First experience in Rwanda

Conjoined twins are identical or monozygotic twins whose bodies are joined in utero. Pygopagus or Iliopagus twins are a type of conjoined twins in which two bodies joined back to back at the buttocks. Surgical Separation of conjoined twins is extremely risk of death and life threatening. Female pygopagus twins of three months were been operated and separated at Kigali Teaching University Hospital. For both babies a posterior sagittal anorectoplasty was performed with derivated ileostomy without problem. No complications occurred during the operation, oral feedings was done at third postoperative day. Ileostomy closure was done three weeks after and babies were discharged from neonatology unit at 35th postoperative day. Adequate preoperative investigation with a well organized and trained team contributed a lot to the success of conjoined twins separation