[Prescription And Delivery's Survey Of Benzodiazepines In The Occurrence Of Addictions At Mbour's District]. / Evaluation De La Prescription Et De La Delivrance Des Benzodiazepines Dans La Survenue Des Addictions Dans Le District Sanitaire De Mbour.

Impact of the prescription and delivery of benzodiazepines in the occurrence of addictions in the district of Mbour. INTRODUCTION: Benzodiazepines (BZD) are widely used nowadays and are at the origin of an addiction. OBJECTIVES: The objective was to evaluate the quality of benzodiazepine prescribing and delivery in the Mbour department of Senegal and subsequently to implement an addictovigilance strategy. Thus, we studied the prescribing habits, the quality of delivery and identified the consumption habits of these drugs. MATERIALS AND METHODS: It was a cross-sectional, prospective study with two questionnaires: addressed to patients and prescribers, conducted in pharmacies, hospitals, districts and Mbour health posts. RESULTS: 44% of BZD prescriptions were prescribed by doctors and especially general practitioner. 31.1% did not comply with the rules of prescription (marketing authorization). As for the dispensing rules, (85.3%) were dispensed without a prescription. The level of consumption was high in the 30-40 age group (43.95%) predominantly female (59%). Insomnia predominated as a reason for prescription (16.4%) on anxiety (11.94%) with (65.5%) dependence. CONCLUSION: The abuses observed in the prescription, the delivery and consumption of BZD, constitutes a real health problem. Half of the consumers become addicted, hence the need for a national addictovigilance program.

INTRODUCTION: Les benzodiazépines (BZD) sont très utilisées de nos jours et sont à l'origine d'une addiction. OBJECTIFS: L'objectif était d'évaluer la qualité de la prescription et de la délivrance des benzodiazépines dans le département de Mbour au Sénégal et ultérieurement mettre en place une stratégie d'addictovigilance. Ainsi, nous avons étudié les habitudes de prescription, la qualité de délivrance et identifié les habitudes de consommation de ces médicaments. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude transversale, prospective avec deux questionnaires : adressé aux patients et prescripteurs, menée dans des pharmacies, hôpital, district et postes de santé de Mbour. RÉSULTATS: 44% des ordonnances de BZD étaient prescrites par des médecins et particulièrement des généralistes. 31,1% ne respectaient pas les règles de prescriptions (hors AMM). Quant aux règles de délivrance, 85,3% étaient délivrées sans ordonnance. Le niveau de consommation était élevé dans la tranche d'âge 30-40 ans (43,95%) avec une prédominance féminine (59%). L'insomnie prédominait comme motif de prescription (16,4%) sur l'anxiété (11,94%) avec (65,5%) de dépendance. CONCLUSION: Les abus observés dans la prescription, la délivrance et la consommation des BZD, constitue un véritable problème de santé. La moitié des consommateurs deviennent addictes, d'où la nécessité de mettre en place un programme d'addictovigilance à l'échelon national.

Estimation of the burden of flu-association influenza-like illness visits on total clinic visits through the sentinel influenza monitoring system in Senegal during the 2013-2015 influenza seasons.

Knowing the burden of influenza is helpful for policy decisions. Here we estimated the contribution of influenza-like illness (ILI) visits associated with laboratory-confirmed influenza among all clinic visits in a Senegal sentinel network. ILI data from ten sentinel sites were collected from January 2013 to December 2015. ILI was defined as an axillary measured fever of more than 37.5 °C with a cough or a sore throat. Collected nasopharyngeal swabs were tested for influenza viruses by rRT-PCR. Influenza-associated ILI was defined as ILI with laboratory-confirmed influenza. For the influenza disease burden estimation, we used all-case outpatient visits during the study period who sought care at selected sites. Of 4030 ILI outpatients tested, 1022 were influenza positive. The estimated proportional contribution of influenza-associated ILI was, per 100 outpatients, 1.2 (95% CI 1.1-1.3), 0.32 (95% CI 0.28-0.35), 1.11 (95% CI 1.05-1.16) during 2013, 2014, 2015, respectively. The age-specific outpatient visits proportions of influenza-associated ILI were higher among children under 5 years (0.68%, 95% CI: 0.62-0.70). The predominant virus during years 2013 and 2015 was influenza B while A/H3N2 subtype was predominant during 2014. Influenza viruses cause a substantial burden of outpatient visits particularly among children under 5 of age in Senegal and highlight the need of vaccination in risk groups.

Closed loop obstruction: pictorial essay.

Closed loop obstruction occurs when a segment of bowel is incarcerated at two contiguous points. The diagnosis is based on multiple transitional zones. The incarcerated loops appear in U or C form or present a radial layout around the location of the obstruction. It's very important to specify the type of obstruction because, in patients with simple bowel obstruction, a conservative approach is often advised. On the other hand, a closed loop obstruction immediately requires a surgical approach because of its high morbidity and the risk of death in case of a late diagnosis.

Apport de l'IRM haut champ dans la prise en charge des cancers du col de l'uterus au Senegal

Objectifs: Decrire le profil des cancers du col de l'uterus au CHU de Fann avec une classification FIGO-IRM et situer l'interet de l'IRM dans la recidive post-operatoire. Patientes et Methode : Etude retrospective monocentrique ayant inclus 30 patientes dont 3 apres chirurgie. Les examens etaient realises avec une IRM de 1;5 Tesla. Des sequences ponderees en T2 dans les 3 plans etaient realisees suivies d'une sequence de diffusion dans le plan axial. Les sequences dynamiques en ponderation T1 etaient realisees dans le plan axial perpendiculaire au grand axe du col; avec saturation de la graisse avant et apres injection de gadolinium. La taille et le signal des tumeurs ont permis de faire une classification FIGO-IRM. La recherche de ganglions et de recidives post operatoires chez trois femmes a ete realisee.Resultats : L'age moyen des patientes etait de 45;7 ans (31 ans-70 ans). La taille moyenne des tumeurs etait de 6;25 cm (2 cm-15;2 cm). Le seuil des 4 cm etait depasse chez 92% des patientes. Toutes les lesions apparaissaient en hyposignal T1; avec restriction de la diffusion. Leur signal en T2 etait variable avec une predominance des lesions en hypersignal intermediaire (72%) et le rehaussement apres injection etait note dans 96% des cas. Le stade II B FIGO-IRM etait le plus representatif (56%) suivi du stade IV A (28%); soit une extension aux parametres dans 84% de cas. Des ganglions suspects etaient notes chez 60% des patientes. Une patiente presentait une recidive post operatoire.Conclusion : L'IRM est devenu quasi incontournable dans le bilan pre-therapeutique et la recherche de recidive post-operatoire des cancers du col de l'uterus dans notre CHU

[Evaluation of erythrocyte deformability in subjects with sickle cell trait during a soccer game: effect of hydration ad libitum]. / Évaluation de la déformabilité érythrocytaire des sujets porteurs de trait drépanocytaire au cours d'un match de football : effet de l'hydratation ad libitum.

This study compared erythrocyte changes between a group of subjects with sickle cell trait (SCT) and controls (subjects without hemoglobinopathy) during a soccer game in two conditions: with and without hydration. Erythrocyte deformability of subjects was assessed by the coefficient of erythrocyte rigidity (Tk) which was calculated before and after football match. Our results showed a significant increase in erythrocyte rigidity (Tk) in SCT at the end of physical activities without hydration; however when water was provided ad libitum their Tk decreased significantly, reaching values of controls. And adequate hydration is recommended in subjects with sickle cell trait during and after exercise.

Idiopathic sclerosing encapsulating peritonitis: a case in an adolescent girl.

Encapsulating peritonitis or "abdominal cocoon" is characterised by part or all of the digestive tube being encased in a thick membrane forming a sort of "cocoon". In addition to secondary forms related to peritoneal dialysis or those with drug related, inflammatory or tumour aetiologies, rare idiopathic forms have been described. We report here a case of an idiopathic form in a 15-year-old adolescent girl.

[Prevalence of child and teenage obesity in schools in Dakar]. / Prévalence de l'obésité de l'enfant et de l'adolescent en milieu scolaire à Dakar.

Obesity is currently viewed as a serious worldwide public health issue. In this survey, we aim to determine its prevalence among schoolchildren and teenagers in Dakar. The sample of our survey consisted of 2,356 students aged 11-17, including 1,110 boys and 1,246 girls. For each of them, we have calculated their body mass index. Based on the higher value of the norm of that index, referred to the 97th percentile of Rolland-Cachera MF's curves, we have identified obese students according to their age and sex. The prevalence of obesity within our sample is 9.34%, with 2.88% for boys and 6.46% for girls. It is at its peak in the age of 11, though there is no significance (p > 0.05) in its decrease (from age 12 to 17). There are significantly (p < 0.05) more obese students in "catholic private" schools than in "public" schools where schooling is free. Child and teenage obesity is a reality in Dakar schools. Consequently, it is advisable to determine its nationwide prevalence to take on its prevention as well as its cure.

[Spiral CT in aortic dissection]. / Place de l'angioscanner dans le diagnostic de la dissection aortique.

Patients with suspected dissection of the thoracic aorta require immediate diagnostic evaluation so that urgent therapeutic interventions can begin. Two women with suspected aortic dissection and one man with abdominal aortic aneurysm underwent color-flow Doppler echocardiography and CT angiography with multiplanar reconstructions. Spiral CT showed ascending aortic dissection (type A Stanford) in two cases and descending aortic dissection (type B Stanford) in one case. It also access the visualization of the intimal flap, the extent of dissection, the size of the aorta, and the presence of pericardial fluid. CT angiography is an accurate diagnostic procedure for patients with suspected aortic dissection and possesses several advantages over other modalities such as transthoracic echocardiography, transesophageal echocardiography and aortography.

Place de l'angioscanner dans le diagnostic de la dissection aortique

La dissection aigue de l'aorte thoracique est une urgence thérapeutique. L'imagerie doit rapidement poser le diagnostic et faire le bilan d'extension. Le but de ce travail est de montrer l'intérêt de l'angioscanner dans le diagnostic de DA à parti de 3 observations. Deux femmes de 40, 43 ans adressées pour dissection aortique thoracique et 1 homme de 60 ans pour anévrysme aorte abdominale ont bénéficié d'une échographie cardiaque et d'un angio-scanner de l'aorte thoraco-abdominale suivi de reconstructions multiplans. La TMD a permis de montrer une dissection de l'aorte ascendante dans 2 cas (stade A de Stanford) et de l'aorte abdominale dans 1 cas (stade B de Stanford) L'angioscanner a visualisé la membrane intimale décollée, précisé l'extension de la dissection, chiffré l'ectasie aortique dans les 3 cas et a monté des signes de gravité à type d'épanchement péricardique. L'angioscanner constitut une alternative fiable dans le diagnostic de DA. Elle est plus sensible que l'échographie transthoracique, moins opérateur dépendant que l'échographie transoesophagienne et plus facile à réaliser qu'une aortographie

Impact of HIV infection on the development, clinical presentation, and outcome of tuberculosis among children in Abidjan, Côte d'Ivoire.

OBJECTIVE: To assess the impact of HIV infection upon the development, clinical presentation, and outcome of tuberculosis (TB) among children. DESIGN: Case-control study and prospective cohort study. METHODS: From March 1994 to November 1995, children aged 0-9 years with newly diagnosed TB were enrolled at the two outpatient TB centers and the two principal university hospitals in Abidjan, Côte d'Ivoire. Children were examined, blood samples were collected for HIV serology and lymphocyte phenotyping, chest radiography was performed, and gastric aspirates and sputum samples were collected for acid-fast bacilli smear and culture. Children were then followed every 2 months during a standard 6-month course of anti-TB therapy. To examine risk factors for TB, age- and sex-matched healthy control children were enrolled from among the siblings of children referred for TB skin testing. RESULTS: Overall, 161 children with TB were enrolled, including 39 (24%) with culture-confirmed pulmonary TB, 80 (50%) with clinically diagnosed pulmonary TB, and 42 (26%) with extrapulmonary TB. Children with TB were significantly more likely than 161 control children to be HIV-seropositive (19 versus 0%), to have a past TB contact (55 versus 16%) and to live in very low socioeconomic status housing (24 versus 6%). No significant differences between HIV-seropositive and seronegative children were found in the distribution of radiologic abnormalities for pulmonary TB or in the site of extrapulmonary TB. The mortality rate in HIV-seropositive children was significantly higher than in seronegative children (23 versus 4%; relative risk, 3.6; 95% confidence interval, 2.0-6.6), and all deaths in HIV-seropositive children with available lymphocyte subtyping results occurred in those with a CD4 percentage of < 10%. CONCLUSIONS: This study documents the importance of HIV infection as an independent risk factor for the development of TB in children, and demonstrates that HIV-related immunosuppression is a critical risk factor for mortality in this population.