[Extrapodal mycetomas in Senegal: epidemiological, clinical and etiological study of 82 cases diagnosed from 2000 to 2020]. / Les mycétomes extrapodaux au Sénégal : étude épidémiologique, clinique et étiologique de 82 cas diagnostiqués de 2000 à 2020.

Objectives: Although the foot remains the main localization of mycetomas, extrapodal attacks, which are rarely studied, are also possible and occur either initially or following an extension. The objectives were to describe the epidemiological, clinical and etiological features of extrapodal mycetomas in Senegal. Methodology: Cross-sectional and retrospective study with multicentric enrollment in four reference department, two of which are in dermatology and two in orthopedics and traumatology. We included the files of patients with extrapodal mycetoma followed from January 2000 to December 2020. The data were analysed with SPSS software. Any p less than or equal to 0.05 was statistically significant. Results: We collected 82 cases representing 39% of mycetoma cases (n = 210). The average age was 41.9. The sex ratio was 3.1. Professionally, most patients were active farmers in 51% of cases (n = 33), pastoralists and housewives in 9 % (n = 6) respectively. The mean duration of evolution was 7.5 years. Exclusively extrapodal topographies were noted in 84% of cases (n = 69). Foot and extrapodal locations were concomitant in 16% of cases (n = 13). Mycetoma foci were distributed as follows: 59 in the trunk, 47 in the lower limbs, 9 in the upper limbs, 1 in the scalp and 1 in the neck. The etiology was actinomycotic in 46% of cases (n = 38), fungal in 38% (n = 31). It was not specified in 16% of cases (n = 13). Bone involvement occurs after 5 years (p = 0.001) unrelated to the etiology (p = 0.6). Conclusion: Extrapodal mycetomas are secondary to direct inoculation. However, extension to bone is exclusively due to diagnostic delay. Periodic consultations in endemic areas combined with training of resident health personnel are necessary for early diagnosis in order to improve the prognosis.

[Evaluation of motivational factors of adolescent patients for orthodontic treatment using the Q methodology]. / Évaluation des facteurs de motivation des patients adolescents pour le traitement orthodontique par la méthodologie Q.

The management of adolescents in the orthodontic practice remains a challenge in terms of motivation and adherence to treatment. Some factors seem to be of paramount importance in the success of treatment. The objective of the present study was to evaluate the motivational factors of adolescent patients seeking orthodontic treatment using the Q methodology. After interviews with adolescent patients, 32 reasons for seeking orthodontic treatment were identified and ranked in order of importance on a Q methodology grid by 40 patients aged 10 to 16 years. Factor analysis was used to classify the patients' views into groups of shared opinions. Four motivating factors were identified in adolescent patients. However, the factor « the advice of general Dentist and the aesthetic need ¼ was the most important. An effective treatment strategy can be chosen for each patient according to their motivational profile; this could therefore improve their cooperation and guarantee a more satisfactory therapeutic outcome.

Apport de la TDM thoracique pour le dépistage de la COVID-19 et impact médico-économique de la pandémie à COVID-19 au service de radiologie de Fann (Dakar-Sénégal) / Contribution of thoracic CT for COVID-19 screening and medico-economic impact of the COVID-19 pandemic in the radiology department of Fann (Dakar-Senegal)

Objectifs :Évaluer l'apport de la TDM thoracique dans le diagnostic des patients suspects de COVID-19en comparaison avec la technique de référence (RT-PCR) et déterminer l'impact médico-économique de la COVID-19 au service de radiologie du CHU de Fann. Matériels et méthodes: Il s'agissait d'une étude rétrospective, descriptive sur une période de 4 mois allant du 1er avril au 31 Juillet 2020, au service de radiologie du CHU de Fann.Ont été inclus les patients reçus pour suspicion clinique de COVID-19, qui avaient eu une TDM thoracique et un prélèvement naso-pharyngé par écouvillonnage pour RT-PCR, soit au total 314 patients. Nous avons étudié les données épidémiologiques, cliniques, les images évocatrices de COVID-19 (opacités en verre dépoli, condensation, topographie lésionnelle), existence ou non d'une embolie, les anomalies en faveur de surinfection, les lésions associées, l'impact sur la fréquentation des différentes modalités etl'impact sur les recettes. Résultats:L'âge médian était de 62 ans et le sex-ratio 1,61. La fièvre a été présente chez 7 patients (2,23%); la toux chez 17 patients (5,41%); la dyspnée chez 30 patients (9,55%) et un syndrome de détresse respiratoire chez 63 patients (20,07%). La clinique n'a pas été précisée chez 163 patients (51,91%). La TDM thoracique était normale chez 20 patients (6,37%), évocatrice de COVID-19 chez 274 patients (87,26%) et non évocatrice de COVID-19 chez 20 patients (6,37%). La RT-PCR était positive chez 125 patients soit 39,80%. La sensibilité et la spécificité de la TDM étaient respectivement de 91,2% et 15,34%. La valeur prédictive positive, la valeur prédictive négative et le taux de précision étaient respectivement de 42%, 72,5% et 45,5%. La baisse du taux de fréquentation était de 59% en radiographie standard, 55% en échographie, 24% au scanner et 87% en mammographie. Dans notre étude on a noté une baisse de 40% des recettes au second trimestre de 2020 comparativement au premier trimestre. Conclusion: La TDM thoracique a une bonne sensibilité pour le diagnostic de la COVID-19. De ce fait, elle peut être considérée comme un outil principal pour la détection des lésions pulmonaires évocatrices de pneumonie COVID-19. Les impacts médico-économiques de la COVID-19 ont été considérables.

False ground-glass opacity and suspicion of COVID-19, beware of the technique for performing the CT.

Ground-glass opacity is a CT sign that is currently experiencing renewed interest since it is very common in patients with COVID-19. However, this sign is not specific to any disease. Besides, the possibility of false positive ground-glass opacity related to insufficient inspiration during the acquisition of the chest CT should be known. We report the case of a 36-year-old patient suspected of COVID-19 and in whom a second acquisition of chest CT was necessary to remove false ground-glass opacities that erroneously supported the diagnosis of COVID-19.

Un cas de COVID-19 compliqué d´embolie avec deux tests PCR initialement négatifs malgré des signes scanographiques.

La maladie à coronavirus 2019 (COVID-19) déclarée en Chine en fin 2019 s´est rapidement généralisée aux autres continents. Son diagnostic se fait par test PCR (Polymerase Chain Reaction) sur des prélèvements naso-pharyngés. Ce test bien que spécifique est d´une sensibilité moindre comparé à la TDM thoracique. Nous rapportons le cas d´un patient testé négatif à deux reprises et chez qui la TDM retrouvait des signes typiques de COVID-19 et une embolie pulmonaire. Et ce n´est qu´après un troisième test PCR qu´il a été positif. Ce qui montre l´intérêt de répéter plusieurs fois les tests PCR mais également de considérer les signes scanographiques comme argument diagnostic devant induire une prise en charge adéquate.

[Sorting and detection of COVID-19 by low-dose thoracic CT scan in patients consulting the radiology department of Fann hospital (Dakar-Senegal)]. / Tri et détection du COVID-19 par TDM thoracique low-dose chez des patients tout-venant au service de radiologie de l´hôpital de Fann (Dakar-Sénégal).

INTRODUCTION: COVID-19 has spread rapidly since its emergence in China and is currently a global health issue. Its definitive diagnosis is made by PCR on nasopharyngeal swabs. However, this diagnostic test has low sensitivity with delayed results. Hence, thoracic computed tomography represents an interesting alternative. The aims of this study were to assess the frequency of computed tomography (CT) lesions suggestive of COVID-19 and to compare the results of CT and PCR test. METHODS: a prospective study carried out over15 working days and involved 47 patients. These patients were recruited based on the presence of at least 2 clinical signs of COVID-19. Chest CT without contrast according to the "LOW-DOSE" protocol was performed. A PCR test on nasopharyngeal swabs was done in patients with signs suggestive of COVID on CT. A serological test was performed in case of a discrepancy between the CT and PCR results. RESULTS: thoracic CT was abnormal in 38 patients and normal in 9 patients. Lesions suggestive of COVID-19 have been identified in 32 patients. Two patients had lesions of non-specific pneumonia. Tuberculosis lesions were visualized in 3 patients. One patient had lesions of interstitial pneumonia. The mean DLP was 59 mGy.cm with extremes of 25 and 95 mGy.cm. Ground-glass opacity was present in 100% of COVID-19 suspects on CT. The results of the PCR test were the same than CT in 12 patients. The positive predictive value for CT was 37.5%. In 20 patients with COVID lesions on CT, the PCR test was negative with a false positive rate of 62.5%. In the patients with negative PCR test, 4 had a serological test for COVID-19 and this test was positive in 3. CONCLUSION: low-dose chest CT can reduce radiation exposure in COVID-19 patients who are at risk of cumulative dose due to repetitive exam. CT can identify lesions suggestive of COVID-19. It also enables the triage of patients by identifying other diagnoses.

False ground-glass opacity and suspicion of COVID-19, beware of the technique for performing the CT

Ground-glass opacity is a CT sign that is currently experiencing renewed interest since it is very common in patients with COVID-19. However, this sign is not specific to any disease. Besides, the possibility of false positive ground-glass opacity related to insufficient inspiration during the acquisition of the chest CT should be known. We report the case of a 36-year-old patient suspected of COVID-19 and in whom a second acquisition of chest CT was necessary to remove false ground-glass opacities that erroneously supported the diagnosis of COVID-19

[Long-term stability and relapse of deep bite correction: a systematic review]. / Stabilité et récidive à long terme des traitements de la supraclusion : une revue systématique.

INTRODUCTION:  Deep overbite is one of the most common malocclusions and is the most difficult to treat successfully. The real challenge remains the stability of long-term deep overbite correction. A search through the scientific literature revealed only one systematic review on this subject. Given the recent publications on the stability of deep bite correction and the development of new processes designed to avoid relapse of these treatments, this one existing systematic review needs to be updated. The purpose of the present systematic review is to evaluate the long-term stability of deep overbite correction. MATERIALS AND METHODS:  Electronic databases were searched and nonelectronic journals were manually explored for papers on long-term stability and relapse of deep overbite correction. Articles deemed appropriate for inclusion in this review were selected and analyzed. Their scientific quality was assessed and the data they contained were extracted and summarized. RESULTS:  The rate of deep overbite relapse was 47.27%. Patients treated with the straight wire appliance showed a 67.74% relapse rate whereas those treated with the Ricketts biological progressive segmented mechanics appliance displayed a 30.38% rate. Subjects treated towards the end of adolescence presented a 14.3% rate of deep overbite relapse whereas those treated in their early teens or in adulthood had a deep overbite relapse rate of 30% and 30.8%, respectively. Intramuscular injections of botox helped obtain 100% stability in maxillofacial surgery to correct deep bite. CONCLUSION:  Age at initiation of treatment and treatment technique are two factors impacting the long-term stability of deep overbite correction.

Comparison of dental arch measurements according to the grade and the obstructive character of adenoids.

INTRODUCTION: Obstructive adenoid hypertrophy is cited as one of the causes of mouth breathing and leads to disharmony in the development of orofacial structures. The objective of this study was to compare the measurements of dental arches according to the grade and the obstructive character of adenoids. MATERIALS AND METHODS: A cross-sectional study was carried out with 86 children. The grade and the obstructive character of adenoids were determined from Holmberg and Cohen's radiographic methods respectively. Dental arch measurements were taken on dental casts. A t-test and a Chi2 test were performed respectively to compare the quantitative and qualitative variables of dental arches according to the obstructive character. An Anova test made it possible to compare the quantitative variables according to the grade as Holmberg defined it. For variables that showed significant differences, a Post Hoc test was used. The significance level was set at P=0.05. RESULTS: Subjects with obstructive adenoids had a shorter posterior mandibular length (P=0.04) and a greater overbite (P=0.04) than those with non-obstructive adenoids. Those with grade 4 had a greater arch depth (P=0.02) and were more prone to open bite(P=0.03). CONCLUSION: A prevention program involving the otorhinolaryngologist and the orthodontist for subjects with obstructive adenoids or grade 4 is necessary to minimize their influence on dental arch relationships.

Orthopantomographic analysis of the intraosseus position of the maxillary canines.

The aim of this work was to analyse the intraosseous position of the maxillary canine in orthodontic patients. It was an exploratory pilot study prior to the next research work to develop a predictive model based on a regression analysis initially including a large number of variables. 105 subjects from 6 to 12 years from both genders were included in this study. Four variables were used. The study showed that there was no marked gender dimorphism concerning the intrabony position of the canine; the latter is quite similar on both sides, and the older the age, the smaller the angulation of the canine. The values obtained for the angulation of the canine, its depth of impaction, its position in relation to the lateral incisor and the premolars, correspond to an average impaction severity and treatment difficulties.

Cephalometric norms of a Burkina Faso population.

INTRODUCTION: After a clinical examination, in order to implement an appropriate treatment planning, additional examinations such as lateral cephalograms, were performed. They were submitted to a cephalometric analysis such as the Tweed-Merrifield analysis. These cephalometric analyses based on a synthesis of aesthetic criteria established for a Caucasian European-American white people population could not serve as the reference for an African population. The aim of our study was to help establish the cephalometric norms of the Tweed-Merrifield's craniofacial and aesthetic analysis for a consulting population in the city of Ouagadougou. MATERIALS AND METHODS: This is a retrospective cross-sectional descriptive study conducted on a sample of lateral cephalograms selected among the files of patients consulting in the department of dental surgery at the Yalgado Ouédraogo university hospital centre of Ouagadougou. The patients were selected upon their balanced facial aesthetics. The same operator using acetate paper traced cephalogram on radiographs and collected the angular and linear values for the analysis. RESULTS: A total of 84 cephalograms, 42 male lateral cephalograms and the same number of females, were included. Their age ranged from 11 to 21 years old, with a mean age of 14.34 years. The mean SNA angle was 84.94°±2.59, the ANB angle was 4.88°. The vertical dimension was within the mean values, which was not the case for the mandibular incisor axis, very tipped buccally with an IMPA angle of 95.97°. The profile of the African subject was characterized by a closed Z angle. CONCLUSION: The profile of the African subject was rather prognathic, the maxilla and the mandible were prominent in relation to the cranial base. The maxillary-mandibular relationship is Ballard's class II. The typical alveolar biprotrusion must be considered as an ethnical data, which our treatment plans must consider.

Early presentation of traumatic cervical disc herniation with neurologic deficit and without an adjacent bone lesion.

AIM OF THE STUDY: The purpose of this study was to explore clinical features and the operational opportunity of traumatic cervical disc herniation. METHOD: Patients with cervical spine injury (413) were retrospectively reviewed. Six patients with neurological deficits were identified to have disc herniation without adjacent bone lesion. The diagnosis was confirmed by MRI. The Japanese Orthopedic Association (JOA) score was used to assess the severity of clinical symptoms. Different grading systems have been used in analyzing various stages of herniated cervical discs. All patients underwent anterior cervical decompression, insertion of autologous iliac crest graft, and fixation with cervical plate. RESULTS: The causes of injury were road traffic accidents in four patients and sport and domestic accidents in one patient each. There were five patients with single intervertebral disc herniation and one patient with double. Pre-operative JOA score was 14 for three patients, the remaining three patients scored 10, 6, and 3 respectively. At final follow-up, the score was 17 for four patients and 14 for two patients. DISCUSSION: Traumatic cervical disc herniation with neurologic deficit and without adjacent bone lesion is a rare condition. MRI is the golden examination to confirm diagnosis. Early recognition is essential for appropriate therapy and to minimize the extent of neurological deficit. CONCLUSION: The MRI is mandatory in diagnosing different types of traumatic herniated cervical disc. Discectomy and anterior cervical interbody fusion using autologous iliac crest graft are the treatment options.

[Relationships between the size of the adenoids and the dental arch measurements]. / Corrélations entre les dimensions des végétations adénoïdes et les mensurations des arcades dentaires.

INTRODUCTION: Enlarged adenoids are often associated with oral breathing. The latter can impact the dental arches. The purpose of this study was to determine the relationships between dental arch measurements and the size of adenoids. MATERIALS AND METHODS: A cross-sectional study was carried out on 86 children. The dimensions of the adenoids were determined from nine radiographic evaluation methods and the dental arch measurements made on the casts. The association between the grade of adenoids and the dental arch measurements was sought by Spearman correlation. That between the quantitative variables assessing adenoids and dental arch measurements was sought by Pearson correlation. The strength of these associations was analyzed using Cohen's values in 1988. The significance was set at p = 0.05. RESULTS: Palatal depth was significantly and positively correlated with adenoid grade according to the method of Holmberg and Linder-Aronson (rho = 0.55, p = 0.005) and with the adenoid measurements according to the methods of Kemaloglu, Fujioka, Johannesson, De Menezes and Maran with r respectively equal to 0.65, 0.59, 0.63, 0.47, 0.74; and p respectively equal to 0.001, 0.002, 0.001, 0.019, and < 0.001. It was also significantly but negatively correlated with the adenoids measurements according to Hibbert's method (r = -0.52, p = 0.008). Overbite was significantly and negatively correlated with adenoid dimension using the De Menezes method (r = -0.541, p = 0.006). DISCUSSION: The strength of the associations shows that using respectively Maran and De Menezes methods can allow to better highlight the association between the dimensions of the adenoids and the palatal depth and the overbite.

Relationships between the obstructive character of the tonsils and the type of ventilation and lip posture.

INTRODUCTION: The role of obstructive tonsils in ventilatory disorders and abnormal lip posture is widely discussed in the literature but remains controversial. The data reported on the probable relationship between obstructive tonsils and an existing breathing disorder or lip incompetence were subjective. The purpose of this study was to evaluate the relationship between the obstructive character of the tonsils and the type of ventilation and lip posture. MATERIALS AND METHODS: This is a cross-sectional study performed in children aged from 6 to 12 years old. The subjects were divided into two groups (A and B) according to the obstructive or non-obstructive character of the palatal tonsils. Type of ventilation and lip posture at rest were recorded for each child. The collected data were analysed using the SPSS 20.0 software (for Windows). A Student's t-test and a Chi2 test were respectively used to compare quantitative and qualitative variables according to the obstructive character of the tonsils for each group. The level of significance is fixed at P=0.05. RESULTS: The subjects in group B with obstructive palatal tonsils were significantly more likely to oral breathing and lip incompetence than the subjects with non-obstructive tonsils (group A). CONCLUSION: The clinical examination of children with ventilatory and postural disorders with lip incompetence must be directed towards the search for associated obstructive palatal tonsils in order to plan an early etiological treatment. This would allow to avoid subsequent problems in the dentofacial structures.

[Correlation between sagittal photogrammetric measurements of the soft tissue profile and dental arches measurements]. / Corrélations entre les mensurations photogrammétriques sagittales de profil des tissus mous et celles des arcades dentaires.

INTRODUCTION: Sagittal soft-tissue analyses made from photographic records (sagittal photogrammetric analysis of the soft tissues) allow orthodontists to quantify the sagittal dimension and situation of the facial soft tissues. These tissues maintain close anatomical relationships with the underlying dental arches. However, little importance has been given to the description and the comparison of the sagittal soft tissue morphology according to dental arches parameters. The purpose of this study was to determine the correlation between the sagittal photogrammetric soft tissue profile and the dental arches measurements. MATERIALS AND METHODS: A cross-sectional study was performed in a group of students. Standardized facial-profile photographs were taken with each student in natural head position, and relaxed lip posture. Photogrammetric parameters were measured on paper sheet using a graduated ruler. Dental arches measurements were also performed directly into the mouth with an electronic caliper. The strength of the association between sagittal photogrammetric soft tissue measurements and dental arches parameters was investigated by a Pearson's correlation. Results were regarded as significant at p=0.05. RESULTS: The lips protrusion parameters were significantly and positively correlated with the dental arch lengths. The overjet was significantly and positively correlated with Ls/Sn-Sm. The overbite was significantly and negatively correlated with the sagittal labial parameters Ls/N-Ort, Li/N-Ort, Ls-E, Li E, Ls-S, Li S, Ls/Sn-Sm and Li/Sn-Sm. CONCLUSION: The correlations found in this study show the importance of taking into account the soft tissue in the diagnosis and orthodontic treatment of patients.

[Comparison of the dental measurements according to the obstructive character of the tonsils]. / Comparaison des mensurations d'arcades selon le caractère obstructif des amygdales palatines.

INTRODUCTION: The role of obstructive tonsils in dental arches abnormalities is widely discussed in the literature but remains controversial. Data on the probable relationship between obstructive tonsils and the presence of these orthodontic abnormalities are subjective. The objective of this study is to quantify the relationship between the obstructive character of the tonsils and the dental arches measurements. MATERIALS AND METHODS: A cross-sectional study was performed in children aged between 6 to 12 years divided into 2 groups (A and B) according to the obstructive character of the tonsils. Dental intra- and inter-arches measurements are recorded on each child. Data is analyzed using SPSS 20.0 for Windows. A t Student and chi square tests are respectively used to compare quantitative and qualitative variables according to the obstructive character of the tonsils. The level of significance is fixed at p = 0.05. RESULTS: The upper dental arch depth is significantly more important in subjects with obstructive tonsils (group B). Dental arches widths are significantly more important in subjects without obstructive tonsils (group A). Group B subjects are significantly more likely to have class II malocclusions, open bite and posterior cross bite with mandibular lateral deviation than group A subjects. CONCLUSION: Early evaluation of children with obstructive tonsils can prevent dental intra- and inter-arches abnormalities caused by upper airway obstruction. Thus late and more aggressive treatments which are not always as efficient as when they were performed during childhood will be avoided.