Microbiological and environmental assessment of human oral dental plaque isolates.

Plaque-related diseases are amongst the most common ailments of the oral cavity. Streptococcus mutans is the causal agent of dental caries in animals and humans and is responsible for the formation and accumulation of plaques. This study aimed to identify and evaluate the role of the dental plaque isolates and its surrounding environment in plaque formation or inhibition. The study started with the identification of human dental plaque isolates from high caries index patients based on 16S rRNA and Mitis salivarius bacitracin agar (MSB) was used for S. mutans growing. Unexpectedly, the Streptococcus mutans was completely absent. The disc diffusion assay recorded that all the isolates had antimicrobial activity against the S. mutans growth. Enzymes assay revealed that the isolates produced dextransucrase, levansucrase and levanase activity with wide variation degrees. Also, the lactic acid production assay was done based in pH shift assessment. The highest pH shift and dextran yield were detected by the isolates Bacillus subtilis_AG1 and Bacillus mojavensis_AG3. The adherence test revealed that Lysinibacillus cresolivorans_W2 (MK411028) recorded the highest adhesion property (60%). Oligo- and polysaccharides were synthesized by the action of dextransucrase enzyme and their cytotoxicity tests were negative. Dextran with a molecular weight (117521 Da) recorded the highest antimicrobial efficacy against Bacillus subtilis_AG1 and Bacillusmojavensis_AG3 (65%, 63.5%) respectively. The results concluded that the dextran was the most important factor causing the dental plaque pathogenicity. Also, oral oligo- and polysaccharides might play a role in dental plaque control.

Epidemiological, bacteriological and therapeutic aspects of chronic osteomyelitis in a sub-Saharan environment.

The purpose of this study was to describe the epidemiological and bacterial aspects of chronic osteomyelitis at the regional hospital of Tenkodogo, in Burkina Faso. This prospective study took place at the regional hospital in Tenkodogo during the 3 year-period 2011-2013 and included all cases of chronic osteomyelitis diagnosed during those years. The diagnosis was based on clinical and radiological evidence. In all, 86 patients were identified, with a mean age of 18.5 years, and predominantly male (73 %). The mean time to consultation was 18 months. The most common sites of chronic osteomyelitis were the tibia and femur. Bacteriologically, the pathogen most frequently isolated was Staphylococcus (75.6 %). The pathogens isolated were mostly responsive to gentamicin (75 % of pathogens) and ciprofloxacin (56.2 % of pathogens). Resistance to the combination amoxicillin + clavulanic acid was observed frequently. The treatment included a sequestrectomy and additional long-term antibiotic therapy based on susceptibility testing. The recurrence rate was 5.8 % over a one-year follow-up. Encouraging results can be obtained in chronic osteomyelitis with proper treatment. In this perspective, the isolation of the causative organism and knowledge of its sensitivity to antibiotics are essential information.

Synergistic analgesic, anti-pyretic and anti-inflammatory effects of extra virgin olive oil and ibuprofen in different experimental models of albino mice.

AIM: Olive oil was used in the past as a remedy for many diseases due to its unlimited benefits in health. This study was carried out to assess the analgesic, anti-pyretic and anti-inflammatory activities of extra virgin olive oil (EVOO) at a dose of 8 mL/kg body weight and to compare it with ibuprofen (IBU) as an individual drug therapy and in combination with two different doses of IBU (therapeutic dose 100 mg/kg and low dose 40 mg/kg), on different animal models in albino mice. METHOD: A total of 132 adult healthy male Swiss albino mice were used in this study. The analgesic effect was assessed using acetic acid-induced writhing test. The antipyretic effect was evaluated by brewer's yeast-induced pyrexia, while the anti-inflammatory activity was assessed by two different models; the carrageenan-induced paw edema and the carrageenan-induced peritonitis in which the levels of total leukocyte count (TLC), neutrophil count, prostaglandin E2 (PGE2) and interferon gamma (INF-γ) were measured in the peritoneal exudates. RESULTS: The results revealed significant protection in all the treated groups; however, the combination of EVOO with IBU at its therapeutic dose showed superiority over the two compounds when used separately. CONCLUSION: Using EVOO with the therapeutic dose of IBU showed synergistic effect in controlling the cardinal signs of acute inflammation rather than using non-steroidal anti-inflammatory drugs alone.

Tetryl exposure: forgotten hazards of antique munitions.

BACKGROUND: Older yet still abundant munitions such as tetryl present easily forgotten health hazards and associated needs for worker protection. CASE PRESENTATION: Symptoms and findings from 22 workers who were exposed to tetryl are summarized. CONCLUSIONS: This study highlights the health hazards from exposure to tetryl. Occupational health professionals need to maintain vigilance to protect workers from the risks of handling older munitions.

Clinical profile of subdural hematomas: dangerousness of subdural subacute hematoma.

Subacute subdural hematomas are a poorly individualized nosological entity, often equated clinically to chronic subdural hematomas. Yet, their neurological deterioration which is usually rapid seems to distinguish them from chronic subdural hematomas. We wanted to show this dangerousness by establishing the clinically evolving profile of the three types of subdural hematomas. This was a prospective and retrospective study of 63 subdural hematoma (18 acute, 13 subacute, and 32 chronic) patients admitted between 2012 and 2014 in the neurosurgery unit of Lomé University Hospital. Hematomas were classified according to the elapsed time after head injury and blood density on CT. The main parameter studied was the evolution of the Glasgow Coma Score (GCS) in the 3 months following the trauma, enabling to establish an evolving profile of each type of hematoma. The average age of patients was 58.1 years for chronic subdural hematomas and 47.6 years for subacute subdural hematomas. Disease duration before admission was 13.1 days for chronic against 36.6 h for subacute hematoma. The clinical profile shows acute worsening within hours during the second week for patients with subacute hematoma, while it is progressive for patients with chronic hematoma. We noted two deaths, all victims of a subacute hematoma (one operated, one patient waiting for surgery). Iso-density hematoma on CT, especially in a young person, must be considered as a predictive factor of rapid neurological aggravation suggesting an urgent care or increased monitoring by paramedics.

Tetryl exposure: forgotten hazards of antique munitions

BACKGROUND: Older yet still abundant munitions such as tetryl present easily forgotten health hazards and associated needs for worker protection. CASE PRESENTATION: Symptoms and findings from 22 workers who were exposed to tetryl are summarized. CONCLUSIONS: This study highlights the health hazards from exposure to tetryl. Occupational health professionals need to maintain vigilance to protect workers from the risks of handling older munitions.

Apport de la radiographie conventionnelle dans les traumatismes de l'extrémité supérieure du fémur et du bassin de l'adulte dans un hôpital de district au Togo

Objectifs : Etablir le profil épidémiologique des traumatisés, répertorier et décrire les caractéristiques des lésions visibles à la radiologie conventionnelle. Matériels et méthodologie : Il s'est agi d'une étude prospective et analytique de 12 mois (mai 2010 à avril 2011) concernant l'analyse radiographique de 302 examens de la hanche ou du bassin traumatique de l'adulte, colligés dans un service de radiologie d'un centre hospitalier préfectoral. Résultats : Il était noté une prédominance masculine avec sex-ratio 2,6. L'âge moyen des patients était de 60 ans avec des extrêmes de 18 à 95.Les accidents de la voie publique (AVP) dans 60,26% constituaient les plus fréquentes circonstances de survenue des lésions dont la fréquence était de 39,40 %.La radiographie du bassin de face en position couchée (100%), le profil urétral (25%),) et le profil chirurgical d'Arcelin (2,3%) ont été réalisés. Les lésions répertoriées étaient les fractures trochantériennes (40,33 %), les fractures cervicales (30,25 %), les fractures du cotyle (15,9 %) et les luxations (13,44 %). Au niveau du massif trochantérien, les traits de fractures étaient obliques (33,33%), multi-fragmentaires (25%), spiroïdes(22,91%). Au niveau du cotyle les traits dominants étaient obliques (42, 21%) et transversales (36,84 %) . Les fractures du col étaient classées en Garden I (20%), Garden II (,4%), Garden III (48%) et Garden IV (28 %). Les luxations postérieures étaient prédominantes dans 68,75% vs 31,25% de formes antérieures. Conclusion La radiographie conventionnelle reste est un outil de diagnostic indispensable et incontournable dans l'exploration de la pathologie traumatique de la hanche dans les situations d'urgence surtout en milieu rural où font défaut les moyens d'imagerie en coupe et les mains qualifiées

[Results of transosseous reattachment for distal rupture of the biceps tendon. Evaluation of results]. / Réinsertion transosseuse par voie antérieure des ruptures du tendon distal du biceps brachial (biceps brachii [bb]) : évaluation des résultats.

Avulsion of the distal biceps brachii tendon is an uncommon injury. This is a retrospective review of cases operated in our department by transosseous suture fixation on the radial tuberosity, using the single anterior incision. Between 2000 and 2007, a total of 10 patients with distal biceps tendon injury were included. All were men, with an average age of 39 years. The most common mechanism was passive extension against active flexion. The dominant limb was affected in all patients. Clinical diagnosis was the rule. Surgical reattachment to the radial tuberosity through the anterior approach to the elbow was performed. The preoperative period was one week in three cases, between one and three weeks in five cases, and superior to three weeks in two cases. Clinical and instrumental evaluation of the results was done. Average follow-up was 48 months. Subjective results were good in seven cases, acceptable in two cases and poor in one case. Nine patients return to their previous level activity with no limitations. The average range of motion was 0° of extension to 135° of flexion. Strength testing of the injured limbs, compared to the contralateral, using the criteria described by Baker and Bierwagen, revealed a loss of 22% of supination strength and 32% of supination endurance. There was a loss of 14% of flexion strength and 27% of flexion endurance. There were two cases of superficial surgical site infection. There were no cases of nerve damage or heterotopic bone formation. Two main factors were found to explain the poor outcomes: experience of the surgeon and a long preoperative delay. Despite the limitations of this study, we found that transosseous reattachment of the biceps' distal tendon to the radial tuberosity can restore supination. Strength and endurance for supination can be better restored by early intervention. Complications are easily avoided if surgery is performed early and by experts.

Dynamic hip screw and compression plate fixation of ipsilateral femoral neck and shaft fractures.

PURPOSE: To evaluate surgical outcomes of ipsilateral femoral neck and shaft fractures. METHODS: Between April 1997 and September 2004, 29 men and 8 women (mean age, 37 years) underwent fixation of femoral neck and shaft fractures using a dynamic compression plate plus a dynamic hip screw or screws. There were 30 femoral neck and 7 pertrochanteric fractures. Functional results were assessed according to the Friedman and Wyman classification. RESULTS: The mean follow-up period was 49 months. Of the femoral neck fractures, 34 united in a mean of 4 months; 33 of them healed anatomically and one with a 6-degree varus angulation. No osteonecrosis of the femoral head was noted. Of the femoral shaft fractures, 32 united in a mean of 6 months, 5 were non-unions (2 persisted even after revision surgery). Seven patients developed infections (5 superficial and 2 deep), which resolved with debridement and antibiotic treatment. Functional results were good in 29 patients, fair in 5, and poor in 3. CONCLUSION: The use of dynamic hip screws and compression plates for ipsilateral femoral neck and shaft fractures is reliable in achieving bone union with few complications.

Avulsion fractures of the tibial tubercle.

PURPOSE: To retrospectively study the epidemiology and treatment of acute avulsion fractures of the tibial tubercle in 12 patients. METHODS: Records of 12 patients aged 11 to 17 (mean, 14) years with avulsion fractures of the tibial tubercle presenting to our hospital from April 1998 to September 2004 were studied. Patient age, gender, involved side, injury mechanism, clinical and radiographic records, treatment, complications, and outcomes were reviewed. RESULTS: Eight patients injured the right side, 3 the left side, and one both sides. They all engaged in sports or active play during the injury. Two fractures were type IA, one type IB, 2 type IIB, 5 type IIIA, 2 type IIIB, and one type IV. Three patients with type-I fractures and one with a type-IIB fracture were treated with closed reduction and cast immobilisation for 3 to 4 (mean, 3.8) weeks. The remaining 9 fractures were treated with open reduction and internal fixation. The mean follow-up period was 39 (range, 23-59) months. No complications were noted. Ten patients had excellent results and 2 had fair results. CONCLUSION: Closed reduction and cast immobilisation for minimally displaced fractures, and open reduction and internal fixation for displaced fractures resulted in favourable outcomes.

Intramedullary fixation using multiple Kirschner wires for forearm fractures: a developing country perspective.

PURPOSE: To evaluate treatment results of intramedullary fixation using multiple Kirschner wires for diaphyseal forearm fractures. METHODS: Between January 2001 and January 2004, 184 patients (122 men and 62 women) with 288 displaced diaphyseal forearm fractures underwent intramedullary fixation using multiple Kirschner wires. The wires were inserted by opening the fracture site because radiographic facility for closed pinning was unavailable. The time to union, functional recovery, and the complication rates were assessed. RESULTS: 11 patients were lost to follow-up, leaving 173 whose data was analysed. In 167 (97%) of the patients the fractures united, and in 14 (8%) of them union was delayed. The mean time to union for closed fractures was 13 (range, 7-16) weeks and for open fractures it was 15 (range, 12-22) weeks. The mean time in cast was 6 (range, 3-14) weeks. In all, 34/173 (20%) had complications: superficial infection (n=13), deep infection (n=4), cross-union between bones (n=4), open fracture 'needing' a skin graft (n=2), radial nerve palsy (n=3), paraesthesia (n=1), and non-union (n=7). Among the 173 analysed patients, the infection rate was 10% and the non-union rate was 4%. 130 (75%) of the patients had the wires removed; no re-fracture occurred after wire removal. Based on the Anderson criteria, 47 (27%) of the patients attained excellent, 78 (45%) satisfactory, and 39 (23%) unsatisfactory results. In 9 (5%) of the patients, union failed (7 plain non-union and 2 due to chronic osteomyelitis). CONCLUSION: Kirschner wires are much cheaper than plates and screws, and require minimal expertise for insertion and removal. They remain acceptable for stabilising displaced diaphyseal forearm fractures in developing countries.