Video-laryngoscopy introduction in a Sub-Saharan national teaching hospital: luxury or necessity?

Tracheal intubation using Macintosh blade is the technique of choice for the liberation of airways. It can turn out to be difficult, causing severe complications which can entail the prognosis for survival or the adjournment of the surgical operation. The video-laryngoscope allows a better display of the larynx and a good exposure of the glottis and then making tracheal intubation simpler compared with a conventional laryngoscope. It is little spread in sub-Saharan Africa and more particularly in Burkina Faso because of its high cost. We report our first experiences of use of the video-laryngoscope through two cases of difficult tracheal intubation which had required the adjournment of the interventions. It results that the video-laryngoscope makes tracheal intubation easier even in it's the first use because of the good glottal display which it gives and because its allows apprenticeship easy. Therefore, it is not a luxury to have it in our therapeutic arsenal.Pan African Medical Journal 2015; 2

Hématome spontané du méso de l’angle colique droit et du colon transverse compliquant un traitement par anti vitamine K: à propos d’un cas et revue de la littérature

L'hématome spontané du méso de l'angle colique droit et du transverse est une complication rare du traitement anticoagulant par antivitamine K. Nous rapportons un cas d'hématome spontané du méso de l'angle colique droit et du transverse associé à un hémopéritoine de grande abondance chez un patient traité par antivitamine K pour embolie pulmonaire consécutive à une fracture des plateaux tibiaux droits. Le diagnostic doit être fait en urgence. L'échographie abdominale et la tomodensitométrie confirment le diagnostic. Le traitement non opératoire est la règle. Le traitement chirurgical est indiqué en cas de complications telles que la rupture de l'hématome.Pan African Medical Journal 2016; 2

Hernie inguinale en Afrique subsaharienne: quelle place pour la technique de Shouldice?

L'objectif était d'étudier l'aspect épidémio-clinique et thérapeutique de la hernie inguinale selon la technique de Shouldice. Nous avons réalisé une étude  rétrospective, portant sur les patients opérés pour hernie inguinale selon la technique de Shouldice dans le service de chirurgie B du CHU du Point G, Bamako, Mali. Il a été  enregistré 225patients opérés selon la technique de Shouldice. L'âge moyen était de 49 ans +/- 17,7. Il y avait 90,7% (204) hommes soit un sex-ratio de 9,7. Les cultivateurs, les ménagères et les ouvriers ont représenté 51,1% (115). Dans 75,2% (169) les patients ont consulté pour tuméfaction inguinale. En pré opératoire, la hernie était compliquée chez 82 (36,4%) patients dont 24 cas de récidive. L'étranglement herniaire a été la principale complication pré opératoire  58,5% (48/82). Les suites opératoires à un an ont été simples chez 94,2%(210) des patients; elles étaient marquées par 8 cas de récidive, 4 cas de névralgie, 2  cas d'atrophie testiculaire, 1 cas de chéloïde. La technique de Shouldice est la technique de choix pour la cure de la hernie inguinale dans les pays en voie de  développement à cause du bon résultat et son coût peu onéreux par rapport aux autres techniques utilisant des dispositifs médicaux.Key words: Hernie inguinale, technique de Shouldice, récidive

Aptitudes À L’agriculture Des Eaux Souterraines Du Departement d’Agboville (Sud-Est De La Côte d’Ivoire)

In the department of Agboville, farmers are interested in the using of groundwater to improve the performance of their crops. But they didn’t know the effects of this water on the crops without. The main objective of this study is to determine the quality of groundwater to prevent the risk of soil alkalinization and salinization in the department of Agboville. Hydrochemical analysis of 28 wells used for irrigation of crops was carried out. The dry residue (RS), the osmotic pressure (π), Sodium Absorption Ratio (SAR), the percentage of sodium exchange (ESP), salinity potential (SP), and the coefficient or the Kelly ratio (RK) were determined. Wilcox diagram was also applied for this study. The results show that groundwater department are soft and lightly mineralized wiht a low salinity. 75% of samples from groundwater haves low salinity and 25% have an average salinity. The values of the Salinity Potential (SP <5), Kelly Ratio (RK <1) and SAR (SAR <10 méq/L) show that all sampled groundwater are good qualities for agriculture. According to Wilcox diagram, groundwaters are excellent quality for agriculutre. The osmotic pressure ( ), the dry residue (RS) and the conductivity values 75% of the sampled waters are excellent quality and 25% average quality for agriculture. Groundwaters from the department of Agboville have a low risk of alkalizing and can be used in irrigation for most crops

Evaluation of immunization coverage within the Expanded Program on Immunization in Kita Circle, Mali : a cross-sectional survey

Other authors: Sékou Dramé, Karim Sangaré, Karim Diakité, Bréhima Coulibaly, Birama Togola, Aguissa MaïgaA survey in 2006 determined the level of vaccination coverage among children aged 12 to 23 months in Kita Circle (Mali), after implementation of the priority program to improve immunization coverage. According to the vaccination cards, results showed that 59.9% of the children were fully vaccinated, while according to the mothers’ declarations the rate was 74.1%. The study found no difference associated with parents’ knowledge about the expanded immunization diseases, distance from the health centre, or socio-economic status. The evaluation of the vaccination coverage rates shows that there is improvement but that efforts should continue

Diversification of Rice Yellow Mottle Virus and Related Viruses Spans the History of Agriculture from the Neolithic to the Present

The mechanisms of evolution of plant viruses are being unraveled, yet the timescale of their evolution remains an enigma. To address this critical issue, the divergence time of plant viruses at the intra- and inter-specific levels was assessed. The time of the most recent common ancestor (TMRCA) of Rice yellow mottle virus (RYMV; genus Sobemovirus) was calculated by a Bayesian coalescent analysis of the coat protein sequences of 253 isolates collected between 1966 and 2006 from all over Africa. It is inferred that RYMV diversified approximately 200 years ago in Africa, i.e., centuries after rice was domesticated or introduced, and decades before epidemics were reported. The divergence time of sobemoviruses and viruses of related genera was subsequently assessed using the age of RYMV under a relaxed molecular clock for calibration. The divergence time between sobemoviruses and related viruses was estimated to be approximately 9,000 years, that between sobemoviruses and poleroviruses approximately 5,000 years, and that among sobemoviruses approximately 3,000 years. The TMRCA of closely related pairs of sobemoviruses, poleroviruses, and luteoviruses was approximately 500 years, which is a measure of the time associated with plant virus speciation. It is concluded that the diversification of RYMV and related viruses has spanned the history of agriculture, from the Neolithic age to the present

Malaria treatment in remote areas of Mali: use of modern and traditional medicines, patient outcome

Use of official health services often remains low despite great efforts to improve quality of care. Are informal treatments responsible for keeping a number of patients away from standard care, and if so, why? Through a questionnaire survey with proportional cluster samples, we studied the case histories of 952 children in Bandiagara and Sikasso areas of Mali. Most children with reported uncomplicated malaria were first treated at home (87%) with modern medicines alone (40%), a mixture of modern and traditional treatments (33%), or traditional treatment alone (27%). For severe episodes (224 cases), a traditional treatment alone was used in 50% of the cases. Clinical recovery after uncomplicated malaria was above 98% with any type of treatment. For presumed severe malaria, the global mortality rate was 17%; it was not correlated with the type of treatment used (traditional or modern, at home or elsewhere). In the study areas, informal treatments divert a high proportion of patients away from official health services. Patients' experience that outcome after standard therapeutic itineraries is not better than after alternative care may help to explain low use of official health services. We need to study whether some traditional treatments available in remote villages should be considered real, recommendable first ai

Efficacy of Artesunate + Sulfamethoxypyrazine/Pyrimethamine versus Praziquantel in the Treatment of Schistosoma haematobium in Children

BACKGROUND:This study was conducted to determine the efficacy of the antimalarial artemisinin-based combination therapy (ACT) artesunate +sulfamethoxypyrazine/pyrimethamine (As+SMP), administered in doses used for malaria, to treat Schistosoma haematobium in school aged children. METHODOLOGY/PRINCIPAL FINDINGS:The study was conducted in Djalakorodji, a peri-urban area of Bamako, Mali, using a double blind setup in which As+SMP was compared with praziquantel (PZQ). Urine samples were examined for Schistosoma haematobium on days -1, 0, 28 and 29. Detection of haematuria, and haematological and biochemical exams were conducted on day 0 and day 28. Clinical exams were performed on days 0, 1, 2, and 28. A total of 800 children were included in the trial. The cure rate obtained without viability testing was 43.9% in the As+SMP group versus 53% in the PZQ group (Chi(2) = 6.44, p = 0.011). Egg reduction rates were 95.6% with PZQ in comparison with 92.8% with As+SMP, p = 0.096. The proportion of participants who experienced adverse events related to the medication was 0.5% (2/400) in As+SMP treated children compared to 2.3% (9/399) in the PZQ group (p = 0.033). Abdominal pain and vomiting were the most frequent adverse events in both treatment arms. All adverse events were categorized as mild. CONCLUSIONS/SIGNIFICANCE:The study demonstrates that PZQ was more effective than As+SMP for treating Schistosoma haematobium. However, the safety and tolerability profile of As+SMP was similar to that seen with PZQ. Our findings suggest that further investigations seem justifiable to determine the dose/efficacy/safety pattern of As+SMP in the treatment of Schistosoma infections. TRIAL REGISTRATION:ClinicalTrials.gov NCT00510159

L’appendagite aiguë : une étiologie rare à ne pas méconnaître dans les douleurs abdominales: Acute appendagitis: a rare etiology not to be overlooked in abdominal pain

Acute appendagitis is a rare cause of abdominal pain. Its diagnosis is based on medical imaging and its treatment is medical. We report a case of acute appendagitis diagnosed on the abdominal CT scan in the context of epigastralgia. L’appendagite aiguë est une cause rare de douleurs abdominales. Son diagnostic repose sur l’imagerie médicale et son traitement est médical. Nous rapportons un cas d’appendagite aiguë diagnostiquée au scanner abdominal au décours d’une mise au point d’épigastralgies