[Moodle, a credible alternative pedagogy for teaching medicine in a tropical environment to address large numbers and pandemic situations?] / Moodle, une pédagogie alternative crédible d'enseignement de la médecine en milieu tropical pour répondre aux grands nombres et aux situations de pandémie?

Introduction: Moodle is an interactive online education platform, a true virtual amphitheater, breaking down geographical and space barriers, capable of offering continuous education even in times of war or pandemic. Aim: To show the possible contribution of Moodle in the teaching of medicine in tropical environments to respond to large numbers and pandemic situations. Methodology: It was a cross-sectional and descriptive survey. It was conducted in June 2019 at Joseph KI-ZERBO University of Ouagadougou in Burkina Faso. It consisted of a questionnaire submitted to Master 1 students of medicine and to their teachers. The survey focused on the solutions that students would propose to improve their learning conditions, the role that Moodle could play in improving their learning, as well as the prerequisites to be resolved before adopting Moodle. The respondent rate was 75.6% of the entire promotion. Results: For students Moodle is a good alternative to conventional education. However, prerequisites must be fulfilled such as the donation of computer to each student (90.3%), the availability of a good connection for all (96%), their training prior to the use of Moodle. Students found no harm in their online assessment via Moodle provided it was reliable and verifiable when needed. Teachers in 38% wanted teaching to remain traditional, face to face against 62% who advocated its abandonment in favor of new teaching methods like Moodle provided that the right conditions are in place. Conclusion: Moodle is a credible e-learning that can facilitate the management of large numbers and ensure the continuity of lessons learned in a pandemic situation despite the need for containment. However, it must be a mastered technique, applied on prepared ground.

[Oncoplasty by the Thorek technique for lower quadrant cancers in a condition of gigantomastia]. / Oncoplastie selon la technique de Thorek pour cancers des quadrants inférieurs en situation de gigantomastie.

OBJECTIVE: Describe our experience of Oncoplasty according to Thorek in gigantomastia with hard and less plastic breasts and a major ptosis. METHODOLOGY: Thirteen cases of breast carcinoma on gigantomastia operated using the Thorek technique between 2014 and 2019 in Burkina Faso were analyzed retrospectively. The operative indications, technique and results were considered. Breast Q was used to assess patient satisfaction. RESULTS: The indication of oncoplasty by the Thorek's technique was breast lower quadrants carcinoma, associated with a major ptosis, gigantomastia. There was a consequence on the spine in 9 over 13 cases. The breasts were hard and less plastic, making the other breast reduction techniques difficult. This technique helped remove the carcinoma, reduce the volume of the breast and address the ptosis. The patients were satisfied with the volume of the remaining breasts and their aesthetic look. The resection margins were safe. Two cases of aerolar dyschromia were noticed. CONCLUSION: The Thorek technique remains an alternative concerning tumours on gigantomastia, with hard and less plastic breasts and a major ptosis. The results combine carcinological and aesthetic requirements.

So-called "historical" necrotic breast cancers: a terrifying actuality in Africa. The case of Burkina Faso.

Study the epidemiological, diagnostic, and treatment features and outcomes of necrotic breast cancer in women. This observational, longitudinal, and descriptive study covered the period from January, 2011, to the end of May, 2016 at the Surgery and Gynecology Departments of Yalgado Ouedraogo University Hospital and Schiphra Medical Center. The study included all women with necrotic breast cancers. Survival was calculated by the Kaplan Meier method and survival comparison was possible with the log-rank method. À risk of error of 0.05 was allowed. Necrotic cancer accounted for 9.1% of all breast cancers. The median age of the patients was 46 years old. The median interval before consultation was 12.4 months. The histological type was invasive ductal carcinoma in 90.8% of cases. Surgery was performed in 51 patients (52%). It was a palliative (cleaning) procedure in 92.2% of cases. Chemotherapy was performed in 28 patients. Overall survival was 61.8% at 6 months, 39.5% at 1 year, and 9.2% at 3 years. Median survival was 10 months: 13 months for women with surgery and 6 months for those without it (p<0.001). Necrotic breast cancer is still common in Ouagadougou. Surgery is the mainstay of the treatment. Survival is mediocre. It therefore seems urgent to focus on raising population awareness and organizing screening campaigns.

Acute appendicitis due to schistosomiasis: four cases at the Yalgado Ouédraogo University Hospital of Ouagadougou.

Acute appendicitis is a frequent pathology with diverse causes. Although Burkina Faso is a tropical country with endemic schistosomiasis, bilharzial appendicitis remains rare. We report 4 cases of appendicitis due to schistosomiasis that we treated at the university hospital of Yalgado Ouédraogo to call attention to the need for routine review of appendectomy parts. Four male patients, aged 22, 26, 30, and 35 years old, were admitted for abdominal pains. Eosinophilia was observed in one case. The preoperative diagnosis was acute appendicitis in 2 cases and appendiceal peritonitis in 2 others. Appendectomy was performed in all cases. Pathological examination of the appendectomy piece observed acute suppurative appendicitis due to schistosomiasis, specifically, Schistosoma haematobium. All patients received praziquantel for antiparasite treatment. Clinical course was uncomplicated in all cases. Routine antiparasite treatment would make it possible to prevent these cases of bilharzial appendicitis. In addition, routine histologic examination of appendectomy parts would enable us to determine the real frequency of this disease in our country, where bilharziasis is endemic. The treatment is appendectomy and the prognosis is good.

Breast and pleuropulmonary metastasis of multirecurrent scalp dermatofibrosarcoma protuberans: a case report.

BACKGROUND: Dermatofibrosarcoma protuberans is a rare tumor, representing about 0.1% of skin malignant tumors. It is characterized by local aggressiveness with significant potential for recurrence. Although metastasis is rare, it does occur. We report a case of a Burkinabe woman with dermatofibrosarcoma protuberans. CASE PRESENTATION: A 27-year-old Burkinabe woman consulted our institution for a recurrent scalp nodule that had been evolving for 13 years. At clinical examination, she was in good condition with a dry cough. An atrophic scarring alopecic plaque of 15-cm diameter in the right parietal region of the scalp, topped by an erythematous firm nodule measuring 3 × 2 × 2 cm, was noted, as well as a mobile nodule located in the axillary tail of the right breast. Cerebral computed tomodensitometry had not objectified the reach of the vault or the brain. A thoracic scan revealed four intrathoracic tissue masses straight to pleural touch. There were no evolutionary lesions in the abdominopelvic region. Histopathologic examination of the biopsy of the scalp nodule showed a proliferation of fibrous background, with fusiform cells carrying a storiform appearance. These cells had dark, elongated nuclei and showed some mitosis without atypia. The cells expressed CD34 intensely and diffusely. The test results were negative for PS100 and smooth muscle actin. The breast nodule showed the same profile as the scalp nodule. CONCLUSIONS: We concluded on the diagnosis of scalp dermatofibrosarcoma protuberans with breast metastasis and probable pleuropulmonary metastasis.

[Pap smear for mass screening: Results of an African experiment]. / Dépistage de masse par frottis cervicovaginal : résultats d'une expérience africaine.

OBJECTIVES: To assess the impact of smear test in the fight against cervix uteri cancer in Senegal. METHODS: This was a descriptive cross-sectional study of 1836 Pap smears performed in patients over 15 years during several screening campaigns in Senegal conducted between June 2010 and June 2012. We analyzed epidemiological data, pathological smears, and the proposed management. RESULTS: In 69% of cases, the women were less than 45 years old. They were mostly multiparous and did not use contraceptive methods before. The smears were interpreted in 91.4% (n=1661) and were pathological in 5.2% of cases. They revealed mainly atypical squamous cells of undetermined significance, squamous intraepithelial low-grade lesions, and squamous intraepithelial high-grade lesions, respectively in 2.5% (n=46), 1.7% (n=30) and 1% (n=19) of cases. Multiparity, early marriages were the main risk factors. Patients with pathological smars had colposcopy with cryotherapy (23 cases), and colposcopy and biopsy (13 cases). A hysterectomy was performed in 4 cases. CONCLUSION: The pathological smear rate found in this study confirms the interest to continue cervical cancer screening with this practice. Strengthening of its geographical and financial access through a national prevention program will effectively help to lower cases of cervical cancer.

[Acute pancreatitis at the Yalgado Ouedraogo University Hospital in Burkina Faso]. / Les pancreatites aigües au centre hospitalier universitaire (CHU) Yalgado Ouedraogo au Burkina Faso.

AIMS: To study the epidemiological, diagnostic, etiologic, therapeutic and evolutionary aspects of acute pancreatitis in Burkinabe. MATERIALS AND METHODS: We conducted a cross-sectional descriptive study referred from records of patients hospitalized for acute pancreatitis in the Department of General and Digestive Surgery of the Yalgado Ouedraogo University Hospital in Burkina Faso from 1 January 2007 to 31 December 2012. RESULTS: We noted 30 cases of acute pancreatitis, a frequency of 0.46 % of hospitalizations and an annual incidence of 4.6 cases per year. There were 22 men. The average age was 42.7 years. Alcohol consumption was found in 56.7%. The clinical aspects were dominated by abdominal pain (100%). Lipasemia was more than three times normal values in 66.3% of cases. An abdominal ultrasound was performed in 26.7% of cases and an abdominal CT was carried out in 50% of cases. The Balthazar score was evaluated in 15 patients and was lower in stage C in 9 cases. The treatment was mainly medical. The evolution was marked by the occurrence of systemic complications in 40% of patients and one death was recorded. CONCLUSION: Patients suffering from financial hardships present a major handicap for the diagnosis and early treatment.

BUT: Etudier les aspects épidémiologiques, diagnostiques, étiologiques, thérapeutiques et évolutifs de la pancréatite aiguë dans le contexte Burkinabè. MATÉRIELS ET MÉTHODE: Il a été mené une étude transversale à visée descriptive à partir des dossiers des patients hospitalisés pour pancréatite aiguë dans le service de chirurgie générale et digestive du CHUYO du 1er Janvier 2007 au 31 décembre 2012. RÉSULTATS: Trente cas de pancréatite aiguë ont été colligé soit une fréquence de 0,46% des hospitalisations et une incidence annuelle de 4,6 cas par an. Il y avait 22 hommes. L'âge moyen était de 42,7 ans. La consommation d'alcool était retrouvée dans 56,7%. Le tableau clinique était dominé par la douleur abdominale (100%). La lipasémie était supérieure à trois fois la normale dans 66,3%. L'échographie abdominale n'a été réalisée que dans 26,7% et le scanner abdominal a été réalisé dans 50%. Le traitement était essentiellement médical. L'évolution a été marquée par la survenue de complications générales dans 40% et un décès a été enregistré. CONCLUSION: Les difficultés financières des patients sont un handicap important pour le diagnostic et la prise en charge précoce.

Les cancers broncho-pulmonaires primitifs à Ouagadougou

Le cancer bronchique primitif est la deuxieme cause de mortalite dans le monde apres les pathologies cardiovasculaires. En Afrique; l'introduction de l'endoscopie a entraine l'augmentation de son 'incidence. Pour avoir une recente idee sur cette affection; nous avons decide de mener une etude retrospective et descriptive a Ouagadougou du 1er janvier 2002 au 31 decembre 2011. Ainsi avons-nous observe une preponderance masculine et un age moyen de 58 ans. La consommation moyenne de tabac a ete evaluee a 15 paquets-annee. Il y avait une predominance de l'atteinte de l'arbre bronchique droit et du carcinome epidermoide. La place du tabagisme a encore ete confirmee comme facteur etiologique