Traumatismes de L’abdomen en Milieu Africain : Aspects Épidémiologiques, Diagnostiques, et Thérapeutiques

Introduction : La prise en charge des plaies et contusions del’abdomen est bien codifiée avec l’existence d’algorithmes. Au Burkina Faso,les ressources humaines, les moyens diagnostiques et thérapeutiques sontlimités. A cet égard, l’objectif de cette étude était d’étudier les aspectsépidémiologiques, diagnostiques et thérapeutiques des traumatismes del’abdomen. Patients et méthodes : L’étude en question était descriptiverétrospective, durant deux ans allant de janvier 2017 à décembre 2018 au CHUSourô Sanou de Bobo-Dioulasso. Les patients inclus avaient un diagnostic deplaie ou de contusion de l’abdomen. Les patients ayant un dossier incompletont été exclus. Résultats : Durant l’étude l’information de 63 patients a étécolligée, 51 hommes et 12 femmes. L’âge moyen était de 22 ans. Les accidentsde la circulation routière étaient au nombre de 25. Parmi ces traumatismesfiguraient 39 contusions et 24 plaies de l’abdomen. Une instabilitéhémodynamique était présente chez 15 patients. Les présentations cliniquesétaient : 25 cas de douleurs abdominales, 14 cas d’hémopéritoine, 12 cas desyndrome péritonéal, 9 cas d’éviscération. Les lésions de la rate étaient présentes dans huit cas. Les polytraumatismes étaient au nombre de 16.L’échographie abdominale était réalisée dans 19 cas, l’ASP dans 22 cas. Letraitement chirurgical a été réalisé chez 26 patients. La laparotomie était nonthérapeutique (ne nécessitant pas de geste chirurgical spécifique) chez 15patients. Les complications postopératoires comportaient cinq cas desuppuration pariétale, un cas de péritonite postopératoire. Le décès étaitsurvenu chez huit (12,7%) patients et la durée d’hospitalisation moyenne étaitde 8,5 jours. Conclusion : Les traumatismes de l’abdomen concernent lesadultes jeunes de sexe masculin, et sont dus aux accidents de la circulationroutière. L’ASP et l’échographie au lit du patient ne sont pasréalisées. Le tauxde laparotomie non thérapeutique est élevé ainsi que la mortalité. Introduction: The management of wounds and contusions of theabdomen is well codified with the existence of algorithms. In Burkina Faso,human resources, diagnostic and therapeutic means are limited. This paperfocuses on studying the epidemiological, diagnostic, and therapeutic aspects of trauma in the abdomen. Patients and Methods: This study employs adescriptive retrospective for two years beginning from January 2017 toDecember 2018 in Sourô Sanou University Hospital of Bobo-Dioulasso. Thepatients included in the study were diagnosed with a wound or contusion ofthe abdomen. Patients with incomplete records were excluded. Results:During the study, the data of 63 patients were collected, 51 men and 12women. The mean age was 22 years old. There were 25 road traffic accidents.Among these injuries were 39 bruises and 24 abdominal wounds.Hemodynamic instability was present in 15 patients. The clinical presentationswere: 25 cases of abdominal pain, 14 cases of hemoperitoneum, 12 cases ofperitoneal syndrome, and 9 cases of evisceration. Lesions of the spleen werepresent in 8 cases and there were 16 polytrauma cases. Abdominal ultrasoundwas performed in 19 cases, abdominal X-rays in 22 cases. Surgical treatmentwas carried out in 26 patients. Laparotomy was non-therapeutic (not requiringa specific surgical procedure) in 15 patients. Postoperative complicationsincluded five cases of parietal suppuration, one case of postoperativeperitonitis. Death occurred in eight (12.7%) patients. The average length ofhospital stay was 8.5 days. Conclusion: Trauma to the abdomen is of interestto young adult males, and it occurs majorly due to traffic accidents. Abdominalx-rays and patient bedside ultrasound are not performed. The rate of nontherapeutic laparotomy is high as well as the mortality. &nbsp

Increasing the uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) through seasonal malaria chemoprevention channel delivery: protocol of a multicenter cluster randomized implementation trial in Mali and Burkina Faso

Background: The uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) remains unacceptably low, with more than two-thirds of pregnant women in sub-Saharan Africa still not accessing the three or more doses recommended by the World Health Organisation (WHO). In contrast, the coverage of Seasonal Malaria Chemoprevention (SMC), a more recent strategy recommended by the WHO for malaria prevention in children under five years living in Sahelian countries with seasonal transmission, including Mali and Burkina-Faso, is high (up to 90%). We hypothesized that IPTp-SP delivery to pregnant women through SMC alongside antenatal care (ANC) will increase IPTp-SP coverage, boost ANC attendance, and increase public health impact. This protocol describes the approach to assess acceptability, feasibility, effectiveness, and cost-effectiveness of the integrated strategy. Methods and analysis: This is a multicentre, cluster-randomized, implementation trial of IPTp-SP delivery through ANC + SMC vs ANC alone in 40 health facilities and their catchment populations (20 clusters per arm). The intervention will consist of monthly administration of IPTp-SP through four monthly rounds of SMC during the malaria transmission season (July to October), for two consecutive years. Effectiveness of the strategy to increase coverage of three or more doses of IPTp-SP (IPTp3 +) will be assessed using household surveys and ANC exit interviews. Statistical analysis of IPT3 + and four or more ANC uptake will use a generalized linear mixed model. Feasibility and acceptability will be assessed through in-depth interviews and focus group discussions with health workers, pregnant women, and women with a child < 12 months. Discussion: This multicentre cluster randomized implementation trial powered to detect a 45% and 22% increase in IPTp-SP3 + uptake in Mali and Burkina-Faso, respectively, will generate evidence on the feasibility, acceptability, effectiveness, and cost-effectiveness of IPTp-SP delivered through the ANC + SMC channel. The intervention is designed to facilitate scalability and translation into policy by leveraging existing resources, while strengthening local capacities in research, health, and community institutions. Findings will inform the local national malaria control policies

Data from an online survey on lentil consumption practices in France in 2022

In a context of transition towards plant-based protein diet, a survey aiming to collect the lentil consumer practices in France in 2022 was performed. There were 607 responses to the survey, of which a large majority (556) were lentil consumers. Amongst those, 283 people indicated that they currently eat more lentils than 5 years ago.The questions were related to type of lentil meals, frequency of consumption, type of preparation, storage duration once cooked etc. (Table 1). There were also general questions on age, gender and region. The survey may be used to obtain information on what type of lentils is consumed (and how often) in France, how it is cooked and stored. This information may be then plugged into a food safety risk assessment to refine, for instance, a microbial exposure model.In particular, of the 21 questions asked, four were about possible leftovers and their duration and two about cooling practices for hot meals. This information is crucial for lentils because consumer information about legumes, especially those prepared at home, is still scarce

Political stability and fiscal consolidation in sub‐Saharan African countries

International audienc

Stabilité du gouvernement et ajustement budgétaire de pays d’Afrique subsaharienne

International audienc

Greening Reversed-Phase Liquid Chromatography Methods Using Alternative Solvents for Pharmaceutical Analysis

The greening of analytical methods has gained increasing interest in the field of pharmaceutical analysis to reduce environmental impacts and improve the health safety of analysts. Reversed-phase high-performance liquid chromatography (RP-HPLC) is the most widely used analytical technique involved in pharmaceutical drug development and manufacturing, such as the quality control of bulk drugs and pharmaceutical formulations, as well as the analysis of drugs in biological samples. However, RP-HPLC methods commonly use large amounts of organic solvents and generate high quantities of waste to be disposed, leading to some issues in terms of ecological impact and operator safety. In this context, greening HPLC methods is becoming highly desirable. One strategy to reduce the impact of hazardous solvents is to replace classically used organic solvents (i.e., acetonitrile and methanol) with greener ones. So far, ethanol has been the most often used alternative organic solvent. Others strategies have followed, such as the use of totally aqueous mobile phases, micellar liquid chromatography, and ionic liquids. These approaches have been well developed, as they do not require equipment investments and are rather economical. This review describes and critically discusses the recent advances in greening RP-HPLC methods dedicated to pharmaceutical analysis based on the use of alternative solvents

La hernie de Littre : à propos d’un cas

La hernie de Littre est l’issue d’un diverticule de Meckel à travers un orifice herniaire inguinal ou crural. C’est une présentation clinique rare du diverticule de Meckel. Le but de ce travail est de rapporter un cas de hernie de Littre et de passer en revue les données de la littérature. Il s’agissait d’un nourrisson de cinq semaines de sexe masculin qui était admis pour une tuméfaction inguino-scrotale droite douloureuse. L’exploration chirurgicale découvrait une hernie inguinale droite indirecte due à une persistance du canal péritonéovaginal. Le sac herniaire contenait l’intestin grêle, présentant un diverticule de Meckel. Une résection segmentaire du diverticule était réalisée. L’examen anatomopathologique montrait un diverticule de Meckelsans hétérotopie tissulaire. Les suites opératoires étaient simples. La hernie de Littre est une pathologie rare de diagnostic peropératoire. Son traitement est la résection segmentaire du diverticule. Tout chirurgien doit être conscient de cette surprise opératoire afin d’éviter ses complications.Mots clés : diverticule de Meckel, orifice inguinal, nourrisson.  Littre hernia is a rare clinical presentation of Meckel diverticulum, which becomes incarcerated in an inguinal orfemoral hernialsac. The aim of this work was to report a case of Littre hernia, and review available literature data. The case was a 5 weeks old male toddler admitted for painful right inguinoscrotal lump. Surgical exploration revealed a right indirect inguinal hernia due to patent ductus vaginalis. The content of the sac was made of the small bowel, showing a Meckel diverticulum. A segmental resection was performed. Histologic examination showed a Meckel diverticulum without tissue heterotopy. Post-operative follow-up was unremarkable. Littre hernia is a rare pathology which is diagnosed per operatively. The treatment is surgical segmental resection. Every surgeon should keep it in mind, in order to avoid its complications.Keywords : Meckel diverticulum, inguinal orifice, infant

Trichoberoard gastrique : Premier cas observe en milieu bur kina be

Le trichobezoard est une concretion de cheveux, de poils ou de fibres de tapis et de debris alimentaire, localisee habituellement dans l'estomac. Le trichobezoard est une pathologie rare qui survient habituellement chez des adolescentes presentant des troubles psychiques. La premiere observation de trichobezoard a ete rapportee en 1 779 par Baudamant lors d'une autopsie chez un homme mort suite a une peritonite par perforation gastrique. Nous rapportons le premier cas en milieu burkinabe, observe en 2013 dans le service de chirurgie generale et digestive du Centre Hospitalier Universitaire Y algado Ouedraogo de Ouagadougou. ll s' est agi d'une jeune femme de 20 ans admise pour une masse epigastrique associee a des vomissements alimentaires. L'interrogatoire avait retrouve des antecedents de trichotillomanie et de trichophagie datant de 4 ans. La fibroscopie digestive haute avait montre un trichobezoard gastrique. Une laparotomie mediane sus-ombilicale, puis une gastrotomie avait permis !'extraction d'un trichobezoard mesurant 32 x 9 x 6 em, pesant 900 g. Les suites operatoires avaient ete simples. La patiente etait sortie au huitieme jour postoperatoire. Elle a ete confiee par la suite a un psychiatre pour suivi therapeutique.Mots-cles : trichobezoard, trichotillomanie, trichophagie, estomac.Gastric trichobezoar : first report case in Burkina EnvironmentThe trichobezoar is a concretion of hair or carpet and food debris fiber, usually  located in the stomach. The first observation trichobezoar was reported in 1779 by Baudamant at autopsy in a man died following gastric perforation with peritonitis. We report the first case in Burkina environment observed in 2013 in General and  Digestive Surgery department of University Hospital Y algado Ouedraogo of Ouagadougou. He acted in a 20 year old woman admitted for epigastric mass  associated with food vomiting. The interrogation had found a history of  trichotillomania and trichophagia dating 4 years. The gastroscopy showed a gastric hairball. A supra-umbilical midline laparotomy and a gastrostomy allowed extracting a hairball measuring 32 x 9 x 6 em, weighing 900 g. The postoperative were simple. The patient was out in the eighth postoperative day. She was later assigned to a psychiatrist for therapy monitoring. The hairball is a rare disease that usually occurs in adolescents with mental disorders.Keywords: trichobezoar, trichotillomania, trichophagia, stomach

Caracteristiques microbiologiques des peritonites aigues generalisees au Centre hospitalier universitaire Souro Sanou de Bobo-Dioulasso

L' objectif de notre etude etait de decrire les caracteristiques microbiologiques des peritonites aigues generalisees excepre les peritonites post-operatoires dans notre hOpital afin de proposer une antibiotherapie probabiliste. Nous avons realise une etude prospective de dix (10) mois qui a concerne tousles cas de peritonites aigues generalisees excepre les peritonites post-operatoires operees et ayant beneficie en per operatoire d'un prelevement de pus. Au total, 72 patients ont ere inclus avec une moyenne d'age de 27,3 ans avec des extremes de 14 mois et 67 ans. L' analyse des 72 echantillons de pus a permis de confirmer 39 cas dont 53 souches bacteriennes isolees ; il y avait une predominance des enterobacteries (58 %) suivi des cocci Gram positif (36 % ). Parmi les enterobacteries, E. coli etait de loin le plus frequent avec 47 %. Chez les cocci Gram positif, les streptocoques predominaient a 22 %. Dans notre serie, une sensibilire plus elevee des germes ala gentamicine, ala ceftriaxone eta la Ciprofloxacine a ere notee. Ces resultats  suggerent une antibiotherapie probabiliste des peritonites dans notre contexte associant les cephalosporines de troisieme generation (C3G) aux aminosides plus un imidazole pour couvrir eventuellement les anaerobies.Mots-cles : peritonites, microbiologie, antibiotherapie. Microbiological characteristics of generalized acute peritonitis at Souro Sanou teaching hospital of Bobo-DioulassoThe objective of this study was to describe microbiological characteristics of  generalized acute peritonitis except the post-operatoire peritonitis in our hospital in order to propose a probabilistic antibiotic therapy. We realized a 10-month transversal prospective study, from July 1", 2012 till May 30'\ 2013.1t concerned all the cases of generalized acute peritonitis except the post-operatoire peritonitis operated and having benefited a taking of pus during surgery. Bacteriological analyses were realized according the protocol of treatment of pus in the laboratory. 72 patients were included. The mean age was of 27, 3 years with extremes of 14 months and 67 years. The analysis of 72 samples of pus allowed to confirm 39 cases and led to identification of 53 bacterial strains. The most common strains were enterobacteriaceae in 58.0%, gram-positive cocci in 36.0%. Escherichia coli  was the most common species (47%) followed by Streptococcus species (22% ). The microbiological confirmation of peritonitis was more frequent in the intervalle 20-30 years old. In our study, a higher  sensibility to gentamycin, ceftriaxon and Ciprofloxacin was noted. On the other hand amoxicillin just like clavulanic  acid-amoxicillin association showed a low activity on the isolates. These findings suggest a probability antibiotic treatment of the peritonitis in our context associating the third generation cephalosporin with aminosides more an imidazol to cover possibly the anaerobic.Keywords: peritonitis, microbiology, antibiotherapy