ABSTRACT
La rétinopathie de Valsalva est une hémorragie rétinienne liée à une manÅuvre de Valsalva qui consiste à une expiration forcée à glotte bloquée après une inspiration forcée. Pathologie rare survenant le plus souvent chez l'adulte entrainant une baisse brutale de l'acuité visuelle de l'Åil atteint. Les auteurs rapportent un cas de rétinopathie de Valsalva, occasionnée par un effort de défécation chez une adolescente drépanocytaire de 17 ans, dans un conteste de constipation. L'absence de lésions vasculaires rétiniennes à l'angiographie oculaire a permis d'écarter la rétinopathie drépanocytaire. Les suites ont été simples
Subject(s)
Adolescent , Anemia, Sickle Cell , Constipation , Cote d'Ivoire , Defecation , Retinal Hemorrhage , Sinus of Valsalva , Visual AcuityABSTRACT
Constipation in children is a universal problem; occurring in 0.7-28 of the population. The exact aetiology is unknown; but the majority of children have a functional; rather than organic; aetiology. Symptoms associated with constipation include abdominal pain; a poor appetite and faecal incontinence; all of which interfere with the quality of life of the child and his or her family. Early intervention with appropriate management is necessary to prevent ongoing sequelae. Once an organic cause has been excluded; a programme of intervention should be implemented; namely evacuation of any faecal mass present; followed by regular maintenance therapy to encourage evacuation of a daily soft stool for at least 2-3 months; prior to gradual withdrawal. Emotional support; exercise and dietary modification are linked to the therapy and will ensure a successful outcome. Failure to implement the protocol may result in ongoing problems in up to 50 of children as they enter adulthood
Subject(s)
Constipation/diagnosis , Constipation/etiology , Constipation/therapy , InfantABSTRACT
Background: The discrepancy in diameters of the resected ends coupled with the heavy faecal loads in the colon of chronically constipated children with Hirschsprung's disease makes definitive primary pull-through procedure quite difficulty in this group. Patients and Methods: Four consecutive patients (aged 5 months to 11 years) who presented with chronic constipation were given warm saline enema along with Castor oil per oram twice daily for 1 week before and 2 weeks after full-thickness biopsies that confirmed Hirschsprung's disease. All patients had intravenous Cefuroxime or Ceftriaxone plus Metronidazole at induction of anaesthesia. Intra-operatively; the levels of resections were 6-8 cm proximal to the most contractile part of the colon adjacent to the transition zone observed after complete division of mesenteric vessels. Results: There were three males and one female; aged 5 months to 11 years. The levels of aganglionosis were in the rectosigmoid region; except one in the descending colon. There was one case each of anastomotic stenoses; mild enterocolitis and deep peri-anal excoriation. The bowel motions were two to four times daily within 1 month post-operatively. Conclusion: It can be concluded from this preliminary study that with pre-operative saline enema and oral Castor oil for about 3 weeks in chronically constipated children with Hirschsprung's disease primary pull-through procedures can be performed successfully. However; further prospective work is required with this method
Subject(s)
Child , Constipation , Hirschsprung DiseaseABSTRACT
Non-motor symptoms (NMS) of Parkinson's disease (PD) are a key determinant of health; quality of life (QoL) and societal cost of PD. They are often less appreciated than motor symptoms but are important sources of disability for manyPDpatients. Literature search was performed using the reference databases Medline; Science Citation Index and EMBASE. The keywords used were 'non-motor symptoms'; Parkinson's disease; olfaction and constipation. Papers discovered by this search were reviewed; as were references cited therein. Contrary to common perception; many NMS of PD occur early in PD and some may even predate the diagnosis of PD that is based on motor signs. These include olfactory deficit; sleep problems such as rapid eye movement behaviour disorder; constipation and the more recently described male erectile dysfunction.There is compelling evidence that nonmotor symptoms of PD play a dominant role in the QoL and disability of PD patients and the QoLof their 'informal' carers. Effective clinical management of PD therefore demands that these symptoms be identified and to the extent possible treated
Subject(s)
Constipation , Erectile Dysfunction , Parkinson Disease/diagnosisABSTRACT
Les auteurs de cet article presentent les resultats d'un essai clinique de type II d'une preparation galenique a base de poudre d'ecorce de tige de Pleleopsis suberosa; utilisee par les therapeutes traditionnels maliens dans le traitement des epigastralgies. Vingt Trois (23) malades ont participe a l'etude; selectionnes apres un examen fibroscopique confirmant le diagnostic d'ulcere gastroduodenal. Treize (13) des malades soit 56;52 pour cent ont completement cicatrise au bout de 30 jours de traitement. Le produit semble agir egalement sur les anorexies; les nausees et les vomissements. Le seul effet secondaire note semble etre la constipation