Outcome of undiagnosed traumatic diaphragmatic injuries: A review of our management

The authors relate on the outcomes of traumatic diaphragmatic injuries unknown early. The files of three patients have been reviewed retrospectively. All of them presented early undiagnosed injuries. The first patient had a left diaphragmatic injury consecutive to a stab wound to the left hypochondrium. The diagnosis was made 18 days later. He died 2 days after operation because of septicaemia. The second patient presented a colonic strangulation through a left diaphragmatic rupture consecutive to a stab wound three years before. A resection and anastomosis to the colon was performed. The patient left the hospital with a definitive pachypleuritis. The third patient was admitted for blunt trauma to the chest with dyspnoea. The chest X-ray showed the diaphragmatic rupture. The peri- operative exploration showed an old rupture with fibrosis banks. The lesion had been respected. The outcomes of early missed traumatic diaphragmatic rupture are various. Their treatment is sometime difficult and dangerous

Les cardiopathies acquises de l’enfant au centre Hospitalo-Universitaire de Bouake: etude preliminaire

Objectifs: décrire les principaux aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs des cardiopathies acquises chez l’enfant au CHU de Bouaké pour améliorer leur prise en charge.Matériels et méthode: Il s’agissait d’une étude rétrospective et descriptive réalisée au CHU de Bouaké de juillet 2016 à Décembre 2016. Elle a concerné tous les enfants âgés de 0 à 15ans diagnostiqués d’une cardiopathie acquise à l’examen clinique et à l’échocardiographie. Les variables d’études portaient sur les aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs.Résultats: Quarante cas de cardiopathies acquises ont été identifiées sur la période de l’étude soit une prévalence hospitalière de 1,81‰. Cette prévalence était de 29% lorsqu’on rapporte le nombre de cas au nombre total de cardiopathies sur la période de l’étude. Toutes les tuniques cardiaques étaient concernées dans des proportions variables et selon l’étiologie : valvulopathies (49% des cas) ; cardiomyopathies (25,5%) et péricardites (24,5%). Il s’agissait surtout d’une insuffisance mitrale rhumatismale (15/40) et d’une péricardite aigue (12/40). Les cardiomyopathies et l’HTA secondaire était rencontré respectivement dans 3 cas /40 et 5 /40. Le taux de mortalité était de 14,7%.Conclusion: Le rhumatisme articulaire aigue reste toujours la grande pourvoyeuse de cardiopathies en Afrique sub aharienne. A noter l’émergence de cardiomyopathie chez l’enfant compliquant souvent une HTA secondaire.Mots clés: Enfant, IM, RAA, cardiomyopathie, HTA, PéricarditeEnglish Title: Acquired cardiopathies of the child in the Teaching Hospital of Bouake (Center OH Ivoiry-Coast): preliminary studyEnglish AbstractObjective: To describe the main epidemiological, diagnostic, therapeutic and progressive aspects of heart diseases acquired in children at the University Hospital Center of Bouake to improve their care.Materials and method: This was a retrospective and descriptive study carried out at the University Hospital Center of Bouake from July 2016 to December 2016. It concerned  all children aged 0 to 15 years diagnosed with acquired heart diseases, on clinical examination and echocardiography. The study variables covered epidemiological, diagnostic, therapeutic and evolutionary aspects.Results: Forty cases of acquired heart diseases were identified during the study period. The hospital prevalence was of 1.81‰. This prevalence was 29% when reporting the number of cases to the total number of heart conditions over the study period. All cardiac tunics were involved in varying proportions and according to etiology: valvulopathy (49% of cases); cardiomyopathy (25.5%) and pericarditis (24.5%). These were mainly rheumatic mitral insufficiency (15/40) and acute pericarditis (12/40). Cardiomyopathy and secondary hypertension were found in 3 cases / 40 and 5/40, respectively. The mortality rate was 14.7%Conclusion: Acute rheumatic fever is still the major provider of heart diseases in sub- Saharan Africa. Note the emergence of cardiomyopathy in children often complicating secondary hypertension.Keywords: Child, mitral insufficiency, acute articular rheumatism, cardiomyopathy, Arterial hypertension, Pericarditi

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

The past 2 years, during which waves of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants swept the globe, have starkly highlighted health disparities across nations. Tegally et al. show how the coordinated efforts of talented African scientists have in a short time made great contributions to pandemic surveillance and data gathering. Their efforts and initiatives have provided early warning that has likely benefited wealthier countries more than their own. Genomic surveillance identified the emergence of the highly transmissible Beta and Omicron variants and now the appearance of Omicron sublineages in Africa. However, it is imperative that technology transfer for diagnostics and vaccines, as well the logistic wherewithal to produce and deploy them, match the data-gathering effort