Effet de l’extrait semi-éthanolique des feuilles de Trema guineensis (Celtidacea) sur la musculature lisse du rat Wistar

L’effet de l’extrait semi-éthanolique de Trema guineensis (Celtidacea) a été étudié sur la musculature lisse du rat Wistar. En effet, sur l’aorte isolée du rat précontracturée avec deux agents contracturants: la noradrénaline (N-adr) (1 µM), et le chlorure de potassium (KCl) (60 mM); l’extrait provoque une relaxation dose–dépendante. Cet effet est aussi important en présence de la N-adr qu’en présence du KCl. L’action de l’extrait sur l’aorte isolée serait due au blocage des canaux calciques. Sur l’iléon isolé de rat précontracturé à la métacholine (MTC) (40 mM), Trema guineensis (Celtidacea) provoquerait une relaxation dose-dépendante. L’extrait aurait une action sur les canaux calciques. En outre, cette solution semi-éthanolique aurait une action similaire (diminution de la contracture) à celle de l’atropine sur l’iléon de rat précontracturé à la MTC. Sur l’utérus isolé de rat, l’extrait appliqué aux doses 4, 6 et 8 mg/ml réduit la fréquence et l’amplitude des contractions de base. Ces résultats montrent que l’extrait de Trema guineensis (Celtidacea) a un effet vasodilatateur sur les structures musculaires lisses, ce qui pourrait expliquer son utilisation dans les cas d’hypertension artérielle, la toux, ou pour ses vertus diurétiques.Mots clés: Trema guineensis; muscles lisses; canaux calcique

How do Spondias mombin L (Anacardiaceae) leaves extract increase uterine smooth muscle contractions to facilitate child birth in parturient women?

Background: Spondias mombin L. (Anacardiaceae) leaves were used in Togolese folk to treat dystocia, expel placenta and manage post-partum hemorrhage during child birth.Objectives: This study aimed to establish how the extract of S. mombin leaves increase uterine smooth muscle contractions relevant to its traditional use to facilitate child birth.Methods: Tests were performed on uterus muscle strips from Sprague-Dawley rats. Central portion of uterine horns were dissected, cleaned of surrounding fat and loose connective tissue, and cut longitudinally into strips which were placed in the organ bath for isometric tension record in presence of different substances.Results: S. mombin leaves extract increased uterine spontaneous contractions. This effect was reduced by indomethacin (2 x 10-6 M), yohimbine (2 x 10-6 M) and 2- aminoethoxydiphenyl borate (2-APB) (5 x 10-5 M), but not by atropine (3.45 x 10-8 M) and cholesterol (2.5 mg/ml).Conclusion: The pharmacological justification for the traditional use of S. mombin leaves to treat dystocia and expel placenta was that its hydro-ethanolic extract induced prostaglandins release, α2-adrenoceptors stimulation, calcium release from internal stores and lifted inhibitory effect of cholesterol on uterine contractions in order to increase uterine smooth muscle contractions.Keywords: Spondias mombin, uterus, contractions, calcium

Effects of Spondias mombin Linn (Anacardiaceae) on rat parturition

The leaves of Spondias mombin Linn (Anacardiaceae) are used by traditional healers in some parts of Africa to treat dystocia and postpartum hemorrhage. All experiments are performed on albino wistar mature and immature rats. This study was undertaken to evaluate the effect of Spondias mombin Linn on rat parturition in order to determine its action on labor time, uterus and sex steroids organs weight and coagulation time. Hydro-ethanolic extract of Spondias mombin leaves were given daily by oral route to female rats from 19th day of pregnancy, at doses of 100; 250 and 500 mg/kg. The dose 250 mg/kg reduced significantly (P < 0,05) labor time. To explore estrogenic activity of the extract, the dose of 250 mg/kg, given daily by oral route to immature female rats for 7 days, induced vaginal opening and the increase in uterus and ovarian weight. The extract at 100 mg/ml was reduced the coagulation time. These results suggest that the leaves hydro-ethanolic extract of S. mombin contain one or more principles which reduced labor time, induced vaginal opening, increased uterus and ovarian weight and reduced coagulation time.Keywords: Spondias mombin, labor time, vaginal opening, uterus, ovarian, coagulation time

Prise en charge de la douleur postoperatoire chez l’enfant au Chu Tokoin De Lome (Togo)

Objectif : Evaluer la prise encharge actuelle de la douleur postopératoire chez l’enfant au CHU-Tokoin de Lomé.Patients et méthodes : Il s’est agi d’une étude rétrospective, descriptive réalisée dans les services de chirurgie pédiatrique et ORL du CHU-Tokoin de Lomé. Tous les dossiers (médicaux et d’anesthésie) des patients âgés de15ans ou moins admis pour une chirurgie programmée, du 1er janvier au 31 décembre 2008 ont été exploités.Résultats et discussion : Les dossiers de 235 patients ont été recensés. Le sexe masculin : 152 (64,68%) patients prédominait avec un ratio de 1,86. La tranche d’âge de 30 mois à 05 ans était la plus représentée.Le type de chirurgie le plus réalisé était la chirurgie ORL avec 102 patients (43,40%). La douleur a été évaluée chez un total de 137 (58,3%) patients. L’évaluation était verbale (as tu mal ?) pour les enfants deplus de 5 ans et observationnelle sur l’existence ou non de pleurs et /ou d’agitation chez les plus petits. L’analgésie post opératoire(APO) a été réalisée selon des associations diverses à base de : Paracétamol,Tramadol, Néfopam, morphine, par voie parentérale, et acide niflumique suppositoires. Cette pratique est très insuffisante et inadéquate en termes d’évaluation de la douleur et de la prescription antalgique au vudes recommandations actuelles. Une formation des praticiens d’anesthésie s’avère indispensable si l’on veut assurer un minimum de qualité en matière d’APO dans notre institution. Objective: The aim was to evaluate postoperative pain management in pediatric patients in our institution.Patients and methods: it was a retrospective and descriptive study made in pediatric surgery and otorhinolaryngology services of CHU Tokoin of Lome. Medical reports of patients aged 0 to 15 years, who undergone a surgery during period of 1st January to 31 December 2008 has been used.Results and discussion: medical reports of 235 patients were used. Male sex was most representative with 152 (64.68%) patients. Age bracket of 30 months to 05 years predominated. Otorhinolaryngology surgerywith 102 (43.40 %) patients was the most practiced. The pain was evaluated for 137(58.3%) patients. This evaluation was verbal (“do you feel pain or not”) for children over 5 years and based on observation ofcrying or agitations for the youngest. Many protocols with various associations with: Paracetamol, Tramadol, Nefopam, morphine IV and niflumic acid suppository was instituted. This practice still beinginsufficient and inadequate as recommended by the guidelines. Continuing training of anesthetists to pain management becomes urgent to ensure the minimum quality to the postoperative pain management in ourhospital

Anesthésie péridurale pour ostéosynthèses du fémur et du tibia chez une femme enceinte

The regional anesthesia seems an interesting alternative for pregnant women because of the risk of general anesthesia in this field. A pregnant woman of 30 years to 29 weeks gestation received a fixation of the femur and tibia in a time under epidural anesthesia after multidisciplinary analysis. An unstable blood pressure was under control during surgery, no complications occurred after surgery.Keywords: Epidural Anesthesia, pregnancy, orthopedic and trauma surgeryJ. Rech. Sci. Univ. Lomé (Togo), 2012, Série D, 14(2) : 47-4

Pratique de la transfusion sanguine perioperatoire au Togo: etude multicentrique nationale

But: relever les différents types, les indications, les modalités et les complicationsde la transfusion sanguine périopératoire. Patients et méthodes : étude prospective, descriptive multicentrique sur 6 mois (1er août 2013 au 31 janvier 2014) sur les transfusions sanguines faites durant la préparation pré opératoire, en per opératoire et au cours des 24 premières heures post opératoires dans les services chirurgicaux au Togo.Résultats: Deux cent soixante-sept patients majoritairement de sexe féminin (sexratio= 0,56) et d'un âge moyen de 33,07 ans (2 à 83 ans) ont été inclus dans l'étude. Ils ont été transfusés lors d'une intervention urgente dans 70,04% des cas. Les chirurgies gynécologique et obstétricale (55,81%), digestive (21,73%) et traumatoorthopédique (17,97%) étaient les plus pourvoyeuses de besoins transfusionnels. Le bilan pré transfusionnel comprenait le groupage sanguin ABO et Rhésus 1 (100%), l'hémogramme (34,83%), le taux d'hémoglobine seul (30,34%) et l'hématocrite seule (20,60%). La transfusion homologue était la plus pratiquée (95,13%). 18,76% des produits sanguins labiles (PSL) ont été transfusés en préopératoire, 66,67% en peropératoire et 14,57% en post opératoire. Ils étaient constitués de 51,88% de concentrés de globules rouges, 24,94% de sang total et 23,18% de plasma frais congelé. Des accidents transfusionnels sont survenus chez 11 patients (4,12%). Il s'agissait d'urticaire (2,62%) et d'hyperthermie avec frissons (1,50%).Conclusion: La transfusion sanguine périopératoire est plus fréquemment pratiquée pour des interventions urgentes. Elle utilise essentiellement les concentrés de globules rouges. L'urticaire constitue l'accident transfusionnel le plus fréquent.Mots clés: Transfusion sanguine, péri opératoire, globule rouge, accident transfusionnelEnglish Title: Practice of perioperative blood transfusion in Togo: multicentric national surveyEnglish AbstractPurpose: Record the different types, indications, procedures and complications of perioperative blood transfusion.Methodology: multicentric cross-sectional descriptive survey over 6 months (1stAugust 2013-31th January 2014) on blood transfusion performed during the preoperative preparation, intraoperatively and during the first 24 postoperative hours in surgical services of Togo.Results: Two hundred sixty-seven predominantly female patients (sex ratio = 0.56) with mean age of 33.07 years (2-83 years) were included. The blood transfusion was performed for an emergent surgery in 70, 04% of cases. Gynecological and  obstetrical (55.81%), digestive (21.73%), trauma and orthopedic surgeries (17.97%) were the largest providers of transfusion requirement. The pre transfusion assessment included ABO blood grouping and Rhesus 1 (100%), complete blood count (34.83%), hemoglobin alone (30.34%) and hematocrit alone (20.60%). Homologous transfusion was the most frequent (95.13%). The labile blood products inclued 51.88% of packed red blood cells, 24.94% of whole blood and 23.18% of fresh frozen plasma. 18.76% of them were transfused preoperatively, 66.67% intraoperatively and 14.57% postoperatively. Transfusion accidents occurred in 11 patients (4.12%). They inclued urticaria (2.62%), hyperthermia and shivering (1.50%).Conclusion: Perioperative blood transfusion is most commonly indicated for emergent surgery. It essentially uses packed red blood cells. Urticaria is the most frequent transfusion accident.Keywords: Blood transfusion, perioperative, red blood cells, transfusion acciden

Ethnopharmacological Survey on Medicinal Plants Used by Traditional Healers in Central and Kara Regions of Togo for Antitumor and Chronic Wound Healing Effects

Cancer is an emerging public health problem in sub-Saharan Africa. Several medicinal plants are used by traditional healers to treat tumors. In Togo, there are no recorded data for these plants but traditional healers claim to cure tumors with some success. So, information on medicinal plants used to cure human tumors and cancer could be of great importance for their widespread use and scientific validation. The present ethnopharmacological survey aims to record information on antitumor plants in central and Kara regions of Togo. Semistructured validated questionnaires were administered to fifty-seven traditional healers specialized in tumor management in 7 prefectures of Togo. Good practices and know-how were recorded. Quantitative ethnobotanical tools were used to analyze and summarize the data collected. 85 recipes of medicinal plants for tumors management are provided. In the local dialect, 78.95% of traditional healers do not have a clear tumor designation and 29.90% find that the causes of tumors remain unknown. According to 48.78% of traditional healers, the diagnosis of tumors in patients is made in the hospital. The types of tumors frequently treated are those of the breast (43.75%) and the lung (16.67%). The seventy listed medicinal plants belong to thirty-nine families, the most represented being Rubiaceae (17.95%), Caesalpiniaceae (12.82%), Fabaceae (10.26%), and Annonaceae (7.69%). The ten most cited species were Xylopia aethiopica, Aframomum melegueta, Khaya senegalensis, Parkia biglobosa, Piliostigma thonningii, Blighia sapida, Vitellaria paradoxa, Adansonia digitata, Annona muricata, and Parinari curatellifolia. Most of the recipes are prepared as decoction (40%) and administered orally (54.12%). Both regions of our study have a wealth of medicinal plants, and traditional healers would use their local knowledge in the management of various tumors and chronic wounds