[Nutritional Status Of Children Under Five During Seasonal Malaria Chemoprevention In 2018 At Kita, Mali: Household Survey]. / Statut Nutritionnel Des Enfants De 6 A 59 Mois Au Cours De La Chimio ­ Prevention Du Paludisme Saisonnier En 2018 A Kita, Mali : Enquete De Menage.

INTRODUCTION: Malaria and malnutrition are among the major causes of morbidity and mortality in children under five in Mali. This study is part of the analysis of the association between both in children under five after a seasonal malaria chemoprevention distribution campaign. METHODS: We carried out a cross-sectional household survey in rural areas after a seasonal malaria chemoprevention distribution campaign to determine the prevalence of malnutrition and parasitaemia in children under five who had passed the season of high transmission of malaria in the health district of Kita. After obtaining written consent, each child was given a physical examination, hemoglobin testing using the Hemocue machine, a thick drop and a thin smear. , A rapid diagnostic test was performed in febrile children. The data was analyzed with ENA 2020 and Stata software version 15.0. Measures of association were made using the chi-square test and a multiple logistic regression model. Odds ratios were used with a 95% confidence interval and a significance level of 0.05. RESULTS: We selected 308 children aged 6 to 59 months. The prevalence of malaria was 13.6%, it was 15%, 17% and 25% respectively for wasting, underweight and stunting. The susceptibility to malaria increased with age and that of wasting decreased with age. There was no significant relationship between malaria disease and nutritional status. CONCLUSION: There is no significant association between malaria and malnutrition in our study.

INTRODUCTION: Le paludisme et la malnutrition font partie des causes majeures de morbidité et de mortalité chez les enfants de moins de cinq ans au Mali. La présente étude s'inscrit dans le cadre de l'analyse de l'association entre le paludisme et le statut nutritionnel après une campagne de distribution de la chimio-prévention du paludisme saisonnier. MÉTHODES: Une enquête transversale auprès des ménages en milieu rural pour déterminer la prévalence de la malnutrition et de la parasitémie chez les enfants de 6 à 59 mois qui ont passé la saison de transmission dans le district sanitaire de Kita. Après l'obtention d'un consentement écrit, chaque enfant a bénéficié d'un examen clinique, d'un dosage du taux d'hémoglobine, d'une goutte épaisse. Un test de diagnostic rapide a été réalisé chez les enfants fébriles. Les données ont été analysées avec les logiciels ENA 2020 et Stata version 15.0. Les mesures de l'association ont été effectuées par l'utilisation du test de Khi deux et du modèle de régression logistique multiple. RÉSULTATS: au total308 enfants âgés de 6 à 59 mois ont été sélectionné. La prévalence du paludisme était de 13,6%, elle était 15%, 17% et 25% respectivement pour l'émaciation, l'insuffisance pondérale et le retard de croissance. La susceptibilité de faire un paludisme maladie augmentait avec l'âge et celle de l'émaciation diminuait avec l'âge. Il n'y avait pas de relation significative entre le paludisme et le statut nutritionnel. CONCLUSION: il n'y a pas d'association significative entre le paludisme et la malnutrition dans notre étude.

[Role Of Imaging In The Management Of A Case Of Intrauterine Device Migration]. / Role De L'imagerie Dans La Prise En Charge D'un Cas De Migration De Dispositif Intra-Uterin.

We report a case of intrauterine device (IUD) migration in order to describe the contribution of imaging in its diagnosis. It was a 35-year-old woman received on 06/01/2018 for pelvic ultrasound for pelvic pain. Ultrasound examination revealed a hyperechoic right para-uterine tubular image. A hysterosalpingography revealed an IUD in the pelvis in extra-urine position. Surgical extraction was done without complications. Intrauterine device migration is rare in our context. The radiological means make it possible to specify its topography.

Nous rapportons un cas de migration de dispositif intra-utérin (DIU) dans le but de décrire l'apport de l'imagerie dans son diagnostic. Il s'agissait d'une dame de 35 ans reçue le 01/06/2018 pour une échographie pelvienne dans le bilan d'une douleur pelvienne. L'exploration échographique a objectivé une image hyperéchogène tubulaire para-utérine droite. Une hystérosalpingographie avait objectivé un DIU dans le bassin en position extra-urine. Uneextraction chirurgicale a été faite avec des suites simples. La migration de dispositif intra-utérin est rare dans notre contexte. Les moyens radiologiques permettent de préciser sa topographie.

[Epidemiological, clinical, therapeutic and evolutionary aspects of pulmonary aspergilloma in Dakar]. / Aspects épidémiologiques, cliniques, thérapeutiques et évolutifs de l'aspergillome pulmonaire à Dakar.

INTRODUCTION: The presentation of pulmonary aspergilloma is dominated by haemoptysis, the results of medical treatment are disappointing and there is significant morbidity and mortality following surgery; the only really curative treatment. These facts emphasise the gravity of this condition. We undertook a study to estimate the current profile of the disease and its management in Senegal. PATIENTS AND METHODS: A retrospective study took place between January 2004 and September 2008 including all the cases of pulmonary aspergilloma diagnosed in private practice and\or the thoracic and cardiovascular surgery service of the Fann Hospital, Dakar. RESULTS: Thirty-five patient records were collected. The sex ratio was four males to one female. The average age of the patients was 43.7 years. All the patients had a history of pulmonary tuberculosis. Serology was positive for Aspergillus fumigatus at 22 patients out of 29 (75.86%). Histological examination of surgical biopsies confirmed the diagnosis in 88.46%. The treatment was essentially surgical with no recorded mortality. Nine cases of haemorrhage and eight of suppuration were reported. CONCLUSION: Surgery remains the reference treatment for pulmonary aspergilloma. In view of the morbidity of this condition we emphasize the importance of early screening and correct treatment of tuberculosis, particularly in endemic countries, to achieve clinical cure and prevent serious after effects.

[Mitral valve repair for rheumatic valve disease in children in Senegal: a review of 100 cases]. / La plastie mitrale sur valve rhumatismale chez l'enfant au Sénégal: 100 observations.

Mitral valve repair is a better therapeutic alternative than valve replacement for rheumatic valve disease in children. Repair procedures are especially well suited to developing countries where heart prostheses and life-long anti-coagulation therapy are largely unaffordable. The purpose of this study was to evaluate medium-term outcome of mitral valve repair in children in Senegal. A retrospective review was conducted in a cohort of 100 patients who underwent mitral valve repair for rheumatic mitral lesions over the 8-year period from 1999 to 2007. Mean age was 12 +/- 5 years (range, 7 to 17 years). The most common symptom of valve disease was dysypnea (stage IV in 26 cases and stage III in 74). Valve lesions were complex with anterior leaflet prolapse in 62 cases, posterior leaflet restriction in 35, commissural fusion in 30, and fusion of chordaes in 54. Repair procedures consisted of transfer and shortening of chordaes in 73 cases in association with commissurotomy in 22 cases and cleft closure in 17. Ring annuloplasty was performed in 84 patients. Hospital mortality was 2%. Postoperative morbidity was characterized by residual mitral regurgitation in four cases. Mean follow-up was 5 years. No late deaths were observed. Outcome was satisfactory in 84 patients with low-grade mitral regurgitation (grade I-II). Reduction of left ventricle diameter was statistically significant during systole and diastole, i.e., from 29.5 +/- 6.2 mm to 33.1 +/- 5.3 mm (p<0.05) and from 47.1 +/- 8.6 mm to 50.5 +/- 9.4 mm (p<0.05) respectively. Improvement in cardiac function was not significant, i.e., from 63.3 +/- 4.8% to 62 +/- 6.4% (p = 0.99). Mitral valve repair was successful in stabilizing myocardial function and remodeling the left ventricle. Outcome is dependent on careful patient selection and evaluation of lesions. Middle-term outcome is encouraging.

[Klippel-Trenaunay syndrome: a case report]. / Le syndrome de Klippel-Trenaunay: a propos d'un cas.

OBJECTIVES: The purpose of this study is to illustrate a rare vascular malformation and to make a literature review. PATIENT: Klippel-Trenaunay's syndrome is a congenital disorder which characterized by capillary malformation, varicosities and bony or soft tissue hypertrophy. This disease is subject to significant morbidity like bleeding, deep vein thrombosis, embolic complications and in some cases enlargement of limb that may require amputation. Our case study was a young woman of twenty years suffering since birth, from a painful, heaviness and enlarged left lower limb that reached 2.5 cm. The distal hypertrophy at the big toe which the site of a botriomycoma (telengectasic granuloma). The inner side of the thigh was also the site of small port-wine stains and varicose of the great saphenous vein. Vascular Doppler ultrasound, skeletal computed tomography and angio-MRI of the limb indicated a klippel-Trenaunay disease. A surgical abstention was decided. The patient underwent only to resection of the toe's botriomycoma followed by an elastic contention associated with "a heel pad compensation" and an anti platelet therapy to prevent deep vein thrombosis and embolic complications. CONCLUSION: The syndrome of Klippel-Trenaunay is a rare vascular malformation. The basic pathology can not be corrected. The treatment's aims are to control varicose veins, to prevent complications and to preserve aesthetic and functional prognosis of the leg.

Artere sous-claviere droite aberrante. Considerations anatomo-cliniques

Introduction : L'artere sous-claviere droite aberrante est une variation anatomique rare de l'origine de l'artere sous-claviere droite qui nait au-dessous de l'artere sous-claviere gauche. Souvent latente; elle peut se reveler par une dysphagie dite dysphagia lusoria.Observations : Les auteurs rapportent trois observations d'artere sous-claviere droite aberrante (arteria lusoria) decouvertes chez des enfants de facon fortuite. Deux cas etaient reveles par la tomodensitometrie respectivement lors du bilan d'une coarctation de l'aorte et d'une pleuresie enkystee et un troisieme de decouverte peroperatoire au moment de la cure palliative d'une tetralogie de Fallot. Dans tous les cas; aucun geste n'etait realise sur la variation anatomique qui etait asymptomatique. Avec l'apport de l'angiographie numerisee; l'anomalie vasculaire doit etre systematiquement recherchee lors du bilan des malformations cardiovasculaires et viscerales chez l'enfant afin de prevenir ses complications et les surprises operatoires. L'indication chirurgicale est reservee a la dysphagie rebelle au traitement medical et aux formes compliquees. A l'occasion de ces observations; les auteurs font une revue de la litterature permettant de proceder a une mise au point de cette affection au plan anatomique; diagnostique et therapeutique

Anesthésie­Réanimation dans la cure complète des cardiopathies congénitales au Sénégal au CHNU de fann

Le but de ce travail etait d'evaluer la prise en charge peri operatoire des cardiopathies congenitales au service de chirurgie thoracique et cardiovasculaire de Fann. Dans cette etude retrospective; 19 patients ont ete colliges sur un an (juin 2006 a juin2007). La tetralogie de Fallot etait la cardiopathie congenitale la plus frequente suivie des communications inter ventriculaires. Le temps moyen de circulation extracorporelle etait de 114 minutes et celui du clampage aortique de 49;78 minutes. Les complications post operatoires etaient metaboliques (7 cas); hemorragiques (5 cas) et infectieuses (2 cas). La mortalite etait de 10;5. La cure chirurgicale permet le retablissement de la physiologie normale et garantit une guerison complete

La plastie mitrale sur valve rhumatismale chez l'enfant au Senegal : 100 observations

La chirurgie mitrale reconstructrice est une alternative de choix au remplacement valvulaire chez l'enfant. Cette chirurgie est adaptee aux pays en voie de developpement ou le cout des protheses cardiaques associees ou non a l'anti coagulation a vie est exorbitant. Le but de cette etude est d'evaluer les resultats a court et amoyen terme de la plastiemitrale chez l'enfant au Senegal. Il s'agit d'une etude retrospective sur 8 ans (1999-2007); concernant 100 patients porteurs d'atteintes valvulaires rhumatismales. L'age moyen etait de 12 +/- 5 ans (7-17 ans). La symptomatologie etait dominee par la dyspnee. Les lesions valvulaires etaient complexes; la fonction myocardique des patients etait conservee et le ventricule gauche dilate. Des gestes (transfert et raccourcissement) etaient effectues sur les cordages (73) completes par des commissurotomies (22) et des fermetures de fentes (17).Une annuloplastie etait realisee chez 84 malades. La mortalite hospitaliere etait de 2. La morbidite post operatoire etait caracterisee par 4 plasties fuyantes. Pour un suivi moyen de 5 ans; il n'y avait pas de mortalite tardive. Les resultats etaient satisfaisants avec 84 patients presentant des fuitesminimes oumoderees. La reduction du diametre du ventricule gauche etait statistiquement significative en systole (29;5+/-6;2 mm vs 33;1+/- 5;3 mm; p 0;05) et en diastole (47;1+/-8;6 mm vs 50;5+/-9;4 mm; p 0;05).Ainsi; la plastie mitrale permet une stabilisation de la fonction myocardique et un remodelage significatif du ventricule gauche; au prix d'une faible morbi mortalite post operatoire. Une analyse lesionnelle precise est determinante. Les resultats a moyen terme sont encourageants

[Right iliac artery aneurism revealed by a left leg ulcer]. / Anévrysme de l'artère iliaque droite révélé par un ulcère de la jambe gauche.

OBJECTIVE: The aim of this study is to expose a secondary cause of venous insufficiency which surgical treatment. OBSERVATION: A 73 old man with a huge aneurism of the right common iliac artery which compressed the left common iliac vein was described. The patient had a unilateral left leg oedema and stasing ulcer. Examinations revealed an abdominal pulsate mass. Echography and T scan showed a right common iliac artery aneurysm and compression of the left iliac vein. Surgery was resected aneurism and replaced vascular prosthesis. After surgery, the unilateral left leg oedema was rapidly regressed and complete stasing ulcer healing. CONCLUSION: This case report showed difficult diagnosis and treatment of vascular disease in under development countries.

[Traumatic manubriosternal joint dislocation in adult: about two surgical cases]. / Luxation manubriosternale traumatique chez l'adulte: apropos de deux cas operes.

Traumatic manubriosternal joint dislocations are rare in adult and occur readily during a violent traumatism of the chest and/or the dorsal spine. We report two cases treated between September 1997 and August 2002 at the Surgical Emergency Department of Le Dantec Hospital. The first observation was related to a 26 year old lady. On September 27, 1997, she fell down from a tree and received all the weight of the body on her two arms. She was referred because of anterior chest pains, increasing with respiration associated with injuries of the 2 wrists. On conventional X-ray, a type II manubriosternal joint dislocation (anterior dislocation of the sternal body with respect to the manubrium) was diagnosed. The mechanism of the dislocation was indirect: flexion-compression of the sternum caused by a hyperflexion of the dorsal spine when the patient touched the ground. There was also a Pouteaux-Colles fracture of the 2 wrists. The dislocation was surgically treated: open reduction followed by manubriosternal stabilization using wires. The 2 wrists were treated by Kapandji procedure. At the 21st postoperative day, a traumatic rupture of the wires required a 2nd internal fixation of the sternum by wires. After 9 years, the patient is without complaint and the chest X-ray is normal. The second observation was that of a 19 year old young woman, referred on August 15, 2002 after a frontal crash with a car while crossing the road. She fell down on her back. She was complaining from severe posterior headaches with a normal Glasgow Scale (15), anterior chest and right hand pains. Radiological examinations showed a fracture of the occipital bone without embarrure and a type I manubriosternal joint dislocation (posterior displacement of the sternal body in relation to the manubrium) which mechanism was direct: direct shock against the sternum. There were also an isolated fracture of 4 right sided ribs and a fracture without displacement of the 3 last bones of the right metacarpus. An orthopaedic treatment was carried out for the lesions of the right hand and an abstention-monitoring suggested for the occipital fracture. The manubriosternal joint dislocation was surgically reduced and stabilized by using a braided polyester thread number 2. After 4 years, the patient is asymptomatic and the manobriosternal joint is stable. We emphasize on the scarcity and the mechanism of traumatic manubriosternal joint dislocations in adult, the frequency of associated injuries and the absence of consensus about their treatment.

The arch of the great saphenous vein: anatomical bases for failures and recurrences after surgical treatment of varices in the pelvic limb. About 54 dissections.

The arch of the great saphenous vein presents numerous tributaries. Misappreciation of their anatomical variations might cause recurrence after surgical treatment of varices. We dissected 54 inguino-femoral regions of fresh, black African corpses. Our purpose was to study the anatomical variations in the vein confluents of the arch of the great saphenous vein; its positions in relation to the external pudendal artery; establish palpable anatomical markers for its surgical approach. The conventional type in a 'vein star' shape was not the most frequent. Upper or abdominal common vein produced through the merging of superficial veins of the anterior abdominal wall and genital or internal common vein were more frequent. An anterior saphenous vein was found in 23 cases. The external pudendal artery crossed beneath the arch of the great saphenous vein cross in 56% of cases and previously in 44% of cases. On average, the top of the arch of the great saphenous vein was projected out 10.88 cm from the ventral and cranial iliac spine, 3.83 cm from the pubic tubercle and 4.19 cm from the inguinal ligament. In view of our results, variations are real. Knowing and taking them into account are essential to prevent recurrences after surgical treatment of varices of the pelvic limb.

[Giant compressive mediastinal lipoma: a case report]. / Lipome géant compressif du médiastin: a propos d'un cas.

Mediastinal lipoma is a rare mesenchymatous fatty tumor in child. Usually asymptomatic, it can cause asphyxiation. The authors report the case of an 18 month-baby-girl referred to us by the pediatric department for asphyxiation. The chest X ray was evocative of a mediastinal tumor. A sudden cardiorespiratory failure leads us to perform thoracotomy. A fatty tumor was found compressing the heart and the left lung. It was easily extirpated. The postoperative recovery was uneventful. Light microscopy showed a lipoma. This compressive form shows the severity of the mediastinal lipoma when it reaches a large size. The literature on this rare pathology is reviewed.

[Complications of treatment of adult's groin hernia: a report of 100 cases comparative study between Bassini and Mac Vay's technics]. / Les complications per et post opératoires précoces de la cure des hernies de l'aine de l'adulte: étude comparative entre les techniques de Bassini et Mac Vay, à propos de 100 cas.

The authors report a prospective study comparing pre and immediate post operative complications of non complicated hernia of the groin in adult treated by operations based on Bassini and Mac Vay technics. It concerned a total of 100 patients made up of two groups of 50 age ranging from 13 to 84 years with an average age of 47 years of whom were 93 males and 7 females. No mortality was registered. The rate of complications was 20% in Bassini's technic and 22% in Mac Vay's technic. There were: bladder injurie, accidental skin wound incurred by the electric surgical blade, meningeal irritation, urinary retention, scrotal sac hematoma, parietal suppuration, intestinal occlusion and immediate recidivation before 6 months. As well as our study as in literature, specific complications related to both technics were rare. We could draw the conlusion that there is no significant superiority of one technic in comparison with the other one.

[Head and neck paragangliomas in Senegal. About 8 cases]. / Paragangliomes de la tête et du cou au Sénégal.

UNLABELLED: Paragangliomas are uncommon neoplasms with rare occurrence in the head and neck area. OBJECTIVE: The purpose of this study was to report the experience of management of these rare tumors by a team of Ear, Nose, and Throat (ENT) surgeons working in the context of a sub-Saharan country. MATERIAL AND METHODS: We conducted a retrospective study in the Ear, Nose and throat Department of a Dakar university hospital. The study concerned 8 patients with a highly vascular tumor located in the neck and temporal bone. The preoperative investigations were computed tomography scanning (CT scan) using contrast injection in 88% and Doppler ultrasonography for the patients with a neck mass. All the patients underwent surgery except one. In 2 cases, the management with a team of vascular surgeons was necessary. Histological examination of the tumor was realized in all cases. RESULTS: The tumor was located in the neck in 5 cases (62,5%) with a carotid body tumor in three patients (37,5%) and vagal location in two (25%). The temporal bone was involved in three patients with a tympano-jugular location (37,5%). All the neck masses were operated on via a unique cervical approach. The tympano-jugular tumors were treated by radical mastoidectomy in two patients. In the third patient with a tympano-jugular tumor, with important involvement of the temporal bone, only the neck extension was operated. The histological diagnosis of paraganglioma was confirmed in all patients. Radiation therapy was delivered in two patients (25%), to complete surgery in the event of extensive temporal bone tumor and exclusive in one case of an inoperable vagal tumor. The outcomes, marked early death in one patient (14%), were good in the short and mid term for the others patients. CONCLUSION: With the improvement of technological infrastructures, particularly with developing modern imaging, we have better knowledge of paragangliomas in the head and neck area, in our experience in a developing country. However, therapeutic approaches are still limited by modest humans and material resources.

[Sternoclavicular dislocations: clinical and therapeutic study. A report of 9 cases]. / Luxations sterno claviculaires: aspects cliniques et thérapeutiques. A propos de neuf cas.

Sterno-clavicular dislocations represent an uncommon pathology in shoulder trauma. The authors describe the anatomical and clinical forms observed between January 1999 and December 2002, and evaluate the treatment process. The retrospective study addressed 9 patients (men only) with an average age of 26.6. Based on the duration of the consulting period, one could distinguish old forms from more recent ones. Diagnosis would help to see anterior forms from posterior forms. Evaluation criteria were: pain, mobility of the shoulder, visibility of the deformation of the sterno-clavicular joint. Six types of anterior dislocations were listed, including 4 recent and 2 old ones. There were 3 recent posterior forms. The anterior recent forms, which were treated in orthopedics, showed a positive evolution. As there was no functional disability, it was wiser to refrain from any treatment of the anterior old forms. The posterior forms, two of them were operated (osteosynthesis) revealed no functional deficit after treatment. However, one of the patients had a broken implant. Scanner facilitated the diagnosis of sterno-clavicular dislocations. The anterior forms, which are more frequent and benign, are different from the posterior forms, which are emergency cases due to the proximity of the aero-digestive and cardiovascular elements. Their surgical stabilization requires techniques related to ligamentoplasty rather than using osteo-synthesis equipment which may move away or break off.

Prise en charge des cas de paludisme simple chez les enfants de 6 mois a 5 ans dans la commune de Baya (Arrondissement de Kangare)

Nous avons evalue les connaissances; attitudes et pratiques des meres sur la prise en charge a domicile des cas de paludisme simple chez les enfants de 6 mois a 5 ans dans la commune de BAYA ( sous prefecture de KANGARE ; prefecture de YANFOLILA) a propos de 400 cas. Notre etude a fait ressortir qu'a Selingue; la prise en charge des cas de paludisme simple se fait dans 51;25a domicile. Deux types de traitement sont adoptes par les meres : Un traitement a base de medicaments modernes (37;5) et de medica- ments traditionnels (56). L'acquisition de medicaments modernes par les femmes s'effectue dans 39des cas dans les structures informelles. 58 Les principales raisons sont d'ordre socio-ecomomico-culturelles : manque d'argent; paludisme considere comme maladie simple et banale; absence d'autorisation du chef de famille a son epouse pour lui permettre de se rendre au centre de sante. Enfin nous constatons qu'il ya un nombre eleve de cas de paludisme PEC a domicile(51;25). Nous estimons qu'il est important d'intensifier les activites d'IEC de sante en direction de la population sur le diagnostic clinique; la PEC et la prevention des cas de paludisme simple chez les enfants de 6 mois a 5 ans