Identification of hazards and critical control points during attiéké (a fermented cassava product) process in Côte d'Ivoire.

Attiéké is the major fermented plant food in Côte d'Ivoire. The aim of this study was to identify hazards and critical control points (CCP) in order to implement a HACCP system for the production of attiéké. Physico-chemical and microbiological analyses were carried out. pH of the cossettes used as raw material for attieke process was slightly acidic (6·5 ± 0·23). But attiéké produced had an acid pH (4·55 ± 0·67). The very high amount of hydrocyanic acid in cassava roots (116 ± 9·42 mg kg-1 ) was reduced to a lower value (3·4 ± 0·14 mg kg-1 ) in attiéké. It was less than the Codex Alimentarus recommended dose (10 mg kg-1 ). Microbiological analysis of the samples revealed the presence of coliforms, bacillus, Staphylococcus aureus and moulds in the intermediate products, the packaged attieke, the utensils, environment and ingredients. During the fermentation and pressing stage, the coliforms disappeared and the loads of Bacillus cereus, S. aureus and moulds were reduced. Cooking eliminated all micro-organisms except B. cereus (spores) whose load was reduced to a value of (1·1 ± 0·4)102  CFU per gram. All these micro-organisms reappeared in attiéké just after packaging. The load of micro-organisms in the packaged attiéké was lower than the Codinorm standard, CCP were cassava roots, the crushing, fermentation, and drying, cooking and packaging stage. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrates the great need to carry out microbiological tests frequently on attieke and even more the need to apply correct HACCP system during the production. This study will make it possible to minimize the problems encountered by women producers of attiéké, ensure consumer safety, face competition from imported starch products (wheat, rice, etc.), contribute to the opening of a small and medium-scale industrialization path for the production of attiéké and strengthen standardization on attiéké to facilitate its export.

Diversity and enzymatic profiles of indigenous yeasts isolated from three types of palm wines produced in Côte d'Ivoire.

AIMS: To investigate the genotypic diversity and enzymatic activity of yeast flora isolated from spontaneous fermenting saps of various palm trees (Borassus aethiopum, Raphia hookeri, Elaeis guineensis) tapped for palm wines. METHODS AND RESULTS: PCR-restriction fragment length polymorphism of ITS-5.8S rDNA combined to 26S rRNA gene and/or the partial ACT1 gene sequencing were applied for yeast characterization, and their enzymatic profiles assessed by using API ZYM kits. Thirteen genera and 23 species were identified, with the highest diversity (14 species) in raffia wine. Saccharomyces cerevisiae was dominant and common to all palm wines. Some potentially pathogenic yeasts were also isolated. The majority of tested strains displayed high amylo-peptidase, phosphatase, ß-glucosidase and α-glucosidase activities and esterase activity. CONCLUSIONS: Diverse yeast species colonized palm wines, among which some were related to a specific type of wine and the majority of them have the ability to digest starch, sugar, protein or lipid. SIGNIFICANCE AND IMPACT OF THE STUDY: This study is a first step in understanding the significance of indigenous yeast flora of palm wines from Côte d'Ivoire. This knowledge is important as a tool for establishing new indigenous yeast collection; which could be used for the product quality improvement and as enzyme sources for biotechnological purposes.

Prise en charge du priapisme chez l'enfant; au CHU de Treichville

Objectif: Le but de cette etude est d'evaluer la prise en charge du priapisme dans notre service en vue de proposer une conduite a tenir a partir d'une revue de la litterature.Patients et methodes: Il s'agit d'une etude retrospective portant sur 7 dossiers de patients suivis pour priapisme dans le service de chirurgie pediatrique du CHU de Treichville; de Janvier 2006 a Octobre 2010. Nous avons analyse: l'age; les antecedents; le delai de prise en charge; l'etiologie; les aspects cliniques; le traitement; et l'evolution.Resultats: Il s'agissait de 7 enfants de race noire; de sexe masculin; ages de 3 ans a 14 ans. Nous avons observe : un priapisme aigu chez 4 enfants (85.71) drepanocytaires SSFA2; un priapisme intermittent chez 2 enfants heterozygotes AS et 1 cas de priapisme intermittent idiopathique. Le priapisme aigu a ete traite chirurgicalement par shunt caverno-balanique unilaterale sans excision d'albuginee selon le procede de Falandry. Le priapisme intermittent a ete traite par l'administration orale d'etilefrine. Apres la chirurgie; nous avons observe 3 bons resultats immediats (75) et 1 bon resultat 24 heures apres. Aucune recidive ni aucun trouble de l'erection n'ont ete observes apres un recul moyen de 14 mois. Conclusion: Le priapisme est une complication frequente de la drepanocytose qui doit etre recherchee et traitee de facon concomitante. Nous preconisons l'injection intracaverneuse precoce d'etilefrine suivie; en cas d'echec; par la chirurgie selon la technique de Al-gorhab modifiee Falandry. Des etudes doivent etre effectuees afin d'apprecier le resultat a long terme; de cette technique; sur la fonction erectile. L'accent doit etre mis sur la sensibilisation afin de prevenir la survenue d'une impuissance sexuelle irreversible

Les complications uro-génitales des traumatismes du bassin: a propos de 41 cas

Objectifs Analyser les donnees epidemiologiques; diagnostiques et therapeutiques des complications uro-genitales de 41 cas de traumatismes du bassin. Patients et methode Il s'agit d'une etude retrospective effectuee a partir de 41 cas de traumatismes du bassin avec complication urinaire et/ou genitale colliges dans le service d'urologie du CHU de Treichville sur une periode de cinq ans. L'age moyen des patients est de 27;8 ans (extremes: 14 a 48 ans); avec un sexe ratio de 9;25 hommes pour une femme. Resultats Les accidents de la voie publique sont les plus grands pourvoyeurs de traumatisme representant 75;6des cas. Les fractures de l'arc anterieur sont les plus incriminees (26;9). Les signes cliniques les plus evocateurs sont : la retention aigue d'urines (16;7); l'uretrorragie (10;4) et l'hematurie (29;1). Nous avons observe 50de lesions uretrales; 38;5de lesions vesicales; 9;6d'atteintes des organes genitaux externes et 1;9de lesions prostatiques. Nous avons opte pour une reparation a distance du traumatisme causal (3 mois) pour les ruptures de l'uretre membraneux en faisant une large part a la resection-anastomose avec spatulation (51;16). Nous avons obtenu 66de bons resultats sur le plan urinaire et 73de conservation d'une fonction erectile satisfaisante tandis qu'une mortalite de 4;9assombrit le pronostic. Conclusion Le pronostic peut etre ameliore par la celerite du diagnostic et la prise en charge des lesions qui sont squelettiques et souvent poly-viscerales chez les patients presentant des lesions uro-genitales consecutifs aux traumatismes du bassin; c'est a dire la necessite d'une prise en charge specialisee pluridisciplinaire

La gangrene perineale a propos de 78 observations

Objectives: To describe the epidemiologic; diagnostic and therapeutic aspects of Fournier's gangrene. Patients and Methods: This retrospective study was carried out on 78 patients (77 males and 1 female) treated for Fournier's gangrene at the University Hospital of Treichville; Abidjan; Cote d'Ivoire; between January 1998 and October 2004. The patients' mean age was 43.3 years (range: 10 - 80 years). Results: The median time elapsed between onset of the infection and consultation was 18 days. A port of entry and predisposing factors could be identified in 43 and 42 patients; respectively. The diagnosis was based on clinical examination. Escherichia coli and Enterobacter aeruginosa were the predominant microbial organisms isolated. Twenty-two patients had to be admitted for intravenous alimentation. All patients were treated by antibiotherapy; excision of necrotic tissues and subsequent wound dressing. Colostomy and cystostomy were performed in 14 patients each. Orchidectomy and penectomy were necessary in 5 and 3 patients; respectively. Healing was achieved without skin graft in 36 patients; while secondary suturing; skin graft and muscle flap were necessary in 18; 6 and 4 patients; respectively. Fourteen patients died from septic shock giving a mortality rate of 17.9. Delayed consultation; shock and predisposing factors such as diabetes mellitus gave a poor prognosis. Conclusion: An early diagnosis; stabilization of the patient's hemodynamic status and debridement of the whole necrotic tissue combined with antibiotherapy will certainly reduce the risk of mortality in patients with Fournier's gangrene

[Nasal carriage of meticillin-resistant Staphylococcus aureus among health care personnel in Abidjan (Côte d'lvoire)]. / Portage nasal de Staphylococcus aureus méticillino-résistant chez le personnel soignant hospitalier a Abidjan (Côte d'Ivoire).

To determine the prevalence of méticillino-résistant Staphylococcus aureus (MRSA) among health care personnel in Abidjan teaching hospitals as well as their resistance profile against other antibiotics, 592 health care personnel from various surgical and medical services: the intensive care unit, gynaecology and obstetrics and third-degree burns services of the Cocody, Treichville and Yopougon Teaching Hospitals were included. The previous nasal pits of each subject included were swabbed. The isolation of S. aureus strains was run in a Chapman medium followed by Identification based on morphological and biochemical characteristics. The resistance profile of the strains to antibiotics was determined by standard Kirby-Bauer disk diffusion method and a 1 microg disc of oxacillin was used for the detection of meticillin-resistance S. aureus strains according to NCCLS (National Committee for Clinical Laboratory Standards) guidelines. 269 members of the studied personnel were carriers of S. aureus, either a rate of portage of 45.4%. Among the 269 S. aureus isolates, 38.7% were MRSA strains and the carriage rate of MRSA in the population was 17.8%. The health care personnel working in surgery was the more colonized (36.7%) follow-up of those of the medical services (31.4%) and of the the intensive care unit (12.4%). A variable proportion of strains of MRSA also expressed resistances to the other families of antibiotics: 27% to aminosids of which 13.5% of phénotype kanamycine, tobramycine, gentamycine (KTG), 58.7% to macrolids and related (MLS), 37.5% to fluoroquinolons, 14.4% to cyclines and 40% to the cotrimoxazole. This confirms their multi-resistant character. The prevalence of MRSA carriage among health care personnel is high; this personnel constitutes an infectious risk for the hospitalized patients who are so exposed to nosocomial infections caused by MRSA.

[Urogenital tuberculosis: diagnostic difficulties in 5 cases]. / La tuberculose urogénitale: difficultés diagnostiques à propos de 5 observations.

OBJECTIVES: The aim of this study is: to emphasize the difficulties of diagnosing genito-urinary tuberculosis because of its non specific symptoms; to incite the physician to seek it more frequently. MATERIAL AND METHOD: Five cases of genito-urinary tuberculosis have been diagnosed within a 10-years period and included in a retrospective study. RESULTS: We found one location in the kidney and one location in the bladder with 2 women diagnosed by repeated urianalysis and 3 cases of location in epididymis diagnosed after surgery. CONCLUSION: Symptoms of genito-urinary tuberculosis are misleading, pathologic findings are taking a more and more important place in the diagnosis, which the new techniques of serologic tests will surely improve.

[Heavy hematuria with shock caused by bladder pheochromocytoma]. / Hématurie abondante avec état de choc occasionnée par un phéochromocytome vésical.

The authors report a case of pheochromocytoma of the bladder revealed by an important gross hematuria with shock. The diagnosis has been established by the pathologist after a partial cystectomy. This location mimmicks a bladder tumor. The diagnosis is difficult; conservative surgery is the rule.

Corporeal plication for surgical correction of penile curvature. Experience with 60 patients.

OBJECTIVE: To evaluate the efficacy of tunica albuginea plication without excision in patients with congenital and acquired penile curvature. METHODS: Results were retrospectively analyzed in 60 consecutive patients treated from 1982 to 1996. Mean age was 42.8 years (range 16-77). 25 patients had congenital curvature and 35 patients had acquired curvature (29 Peyronie's disease, 5 postoperative and 1 posttrauma). All patients had penile curvature with angulation over 30 degrees and major intercourse difficulties. RESULTS: Postoperatively, 52 patients (87%) had satisfactory cosmetic results and 49 (82%) had satisfactory functional results. All patients (100%) with congenital or postoperative curvature had satisfactory cosmetic results and satisfactory functional results. Patients with Peyronie's disease had a lower success rate with 81% satisfactory cosmetic results and 62% satisfactory functional results. CONCLUSION: Tunica albuginea plication is a more simple procedure than tunica albuginea resection (Nesbit procedure) with a comparable success rate and minimal morbidity.

[Modified Nesbit's operation in the treatment of incurvations of the penis. Apropos of 26 cases]. / L'opération de Nesbit modifiée dans le traitement des incurvations de la verge. A propos de 26 cas.

Distortion of the penis can be an obstacle to normal sexual intercourse and can lead to psychological problems. Nesbit first described an operation for the correction of three cases of congenital incurvation of the penis. Several authors later proposed modifications of the original procedure, but the principle technique relies on folding the corpus cavernosum on the side opposite the deviation. We have treated 26 cases with distorted penis: 14 congenital, 3 postsurgical, 1 post-trauma and 8 due to la Peyronie's disease. Our functional results have been excellent. The risk of postoperative retraction is considerably reduced when the fold is created without removing the albugin patches. The quality of the results is directly related to rigorous patient selection.