Craniocerebral Gunshot Injuries in Chad: A Study of 44 Cases.

BACKGROUND: Firearm head injuries cause great public health concern because of their severity. They are life-threatening due to intracranial lesions and sepsis risks. This prospective study evaluates the management of craniocerebral wounds in Chad. METHODS: This is an observational study conducted over a period of 65 months with 44 patients with a ballistic craniocerebral wound (BCW), of which only 7.18% were assessed by neurosurgeons with gunshot wound. RESULTS: The mean age was 30.57 ± 13 years (range:2-60 years). The 21-30 age group was the most affected (31.8%). The sex ratio was 21. A total of 63.6% of cases involved military personnel. The average admission time was 24.95 ± 12 hours (range: 1-72 hours). Explosive device attacks represented 29.5% of cases, of which 53.3% occurred in civilian practice. Point-blank shooting was reported in 70.5% of cases. The entry hole of the projectile was frontal in 40.9%. Intracranial sequestration of the projectile was found in 56.8%. Association of upper limb trauma was found in 9.1% of cases. Brain scans were performed in 95.5% of cases. Surgical treatment was undertaken in 68.18% of cases. The recovery process was marked by brain abscess in 6.8% of cases. Seven deaths were recorded. CONCLUSIONS: This study shows that BCW is frequent and mainly affects young male individuals in Chad. Many of the cases were related to improvised explosive device attacks, especially in civilian practice (70.5%). The delay in diagnostic and therapeutic management favors the high rate of sequelae.

New Laryngeal Foreign Body; Metal Hook.

To our knowledge, no case of a hook inhalation in a child has been reported. However, we report the first case diagnosed in a 12-year-old child located at the laryngeal level and extracted endoscopically without any complications using Magill's forceps.

Statut vaccinal contre le virus de l'hepatite virale B et portage de l'antigene HBs chez les etudiants en medecine et Pharmacie de l'Universite de Douala au Cameroun

Objectif Le but de notre etude etait de determiner la prevalence de l'Ag HBs chez les etudiants en medecine et pharmacie de l'universite de Douala -Cameroun. Methodes Il s'agit d'une etude transversale; descriptive et analytique qui a porte sur les etudiants de la faculte de medecine et des sciences pharmaceutiques de l'universite de Douala-Cameroun. Nous avons inclus tout etudiant regulierement inscrit et acceptant de participer a l'etude. Les prelevements etaient traites par un test rapide puis par ELISA (automatic diagnostic). Les variables qualitatives ont ete comparees par un test de Chi-2; du test de Fischer et de l'Odds ratio. Resultats Cinq cent etudiants ont ete preleves. L'age median etait de 22 ans avec des extremes allant de 16 a 31 ans. Le sex ratio etait de 1;36 en faveur du sexe feminin. L'antigene HBs etait positif chez 28 etudiants soit 5;6. 88 etudiants soit 17;6 etaient vaccines contre l'hepatite virale B. Les etudiants qui avaient recu une; deux et trois doses de vaccin representaient respectivement 5 (n=25); 7;6(n=38) et 17;6(n=88). Huit etudiants soit 4;45 avait fait un dosage de l'anticorps anti HBs pour verifier l'efficacite vaccinale. Conclusion :La prevalence de l'Ag Hbs est de 5;6 chez les etudiants en medecine et pharmacie a Douala

[Hepatitis B knowledge among secondary school students in Côte d'Ivoire]. / Connaissance de l'hépatite virale B par les élèves des écoles secondaires en Côte d'Ivoire.

AIM: The purpose of this study was to assess hepatitis B knowledge among secondary school students' in Côte d'Ivoire in order to promote the inclusion of hepatitis B education in school curricula. MATERIAL AND METHODS: a single cross-sectional survey involving six schools (7,376 students) was conducted. Data were collected using a self-administered questionnaire. RESULTS: All students present on the day of the survey agreed to participate in the study (100%, n = 3,352). The mean age of the participants was 17.9 years (10-26 years), with a male-to-female sex ratio of 1.68. Among them, 2,552 (76.6%) had heard of the HVB. School was the main source of information (12%), after the mass media (62%). The causative agent of the disease was known by 74.1% of students (n = 2,484), sexual transmission by 39.3% (n = 1316), and blood-borne transmission by 57.2% (n = 1919). Respectively 29%, 40% and 41% of the students were aware that acupuncture, body piercing and tattooing are high-risk practices. Only 35.7% of the students knew that there was an effective vaccine. The factors associated with hepatitis B knowledge were: being aged 16 to 20 years (OR = 1.73 [95% CI 1.198 to 2.49]), living in a permanent house or apartment (OR = 1.58 [95% CI 1.234 to 2.02]) or in a house or apartment with no more than 2 persons per room (OR = 1.41 [95% CI 1.15 to 1.74]), being in terminale (final year of high school) (OR = 2.54 [2.01 to 3, 20IC95%]), and having two working parents (OR =1.54 [95% CI 1.25 to 1.88]). CONCLUSION: The students' knowledge of the hepatitis B virus was found to be inadequate and superficial. Early awareness programs provided as part of the official curriculum and measures to improve the social conditions of students should help to improve knowledge in this area.

Usefulness of Noninvasive Predictors of Oesophageal Varices in Black African Cirrhotic Patients in Côte d'Ivoire (West Africa).

Aims. To determine the usefulness of platelet count (PC), spleen diameter (SD) and platelet count/spleen diameter ratio (PC/SD ratio) for the prediction of oesophageal varices (OV) and large OV in black African patients with cirrhosis in Côte d'Ivoire. Materials and Methods. Study was conducted in a training sample (111 patients) and in a validation sample (91 patients). Results. Factors predicting OV were sex: (OR = 0.08, P = 0.0003), PC (OR = 12.4, P = 0.0003), SD (OR = 1.04, P = 0.002) in the training sample. The AUROCs (±SE) of the model (cutoff ≥ 0.6), PC (cutoff < 110500), SD (cutoff > 140) and PC/SD ratio (cutoff ≤ 868) were, respectively; 0.879 ± 0.04, 0.768 ± 0.06, 0.679 ± 0.06, 0.793 ± 0.06. For the prediction of large OV, the model's AUROC (0.850 ± 0.05) was superior to that of PC (0.688 ± 0.06), SD (0.732 ± 0.05) and PC/SD ratio (0.752 ± 0.06). In the validation sample, with PC, PC/SD ratio and the model, upper digestive endoscopy could be obviated respectively in 45.1, 45.1, and 44% of cirrhotic patients. Prophylactic treatment with beta blockers could be started undoubtedly respectively in 36.3, 41.8 and 28.6% of them as having large OV. Conclusion. Non-invasive means could be used to monitor cirrhotic patients and consider treatment in African regions lacking endoscopic facilities.