[Multifocal tuberculosis simulating multimetastatic colon cancer in an immunocompetent black African patient: a case report]. / Tuberculose multifocale simulant un cancer du côlon multi-métastatique chez un Noir africain immunocompétent: à propos d´un cas.

Multifocal tuberculosis is rare in immunocompetent subjects. It is characterized by the involvement of at least two extra-pulmonary sites, associated or not with lung disease. It is often difficult to diagnose. We here report a case of multifocal tuberculosis in a non-immunocompromised black African subject at the Hubert Koutoukou Maga National Hospital and University Center (CNHU-HKM) in Cotonou, Benin. The study involved a 23-year-old man, with no particular previous history, admitted with diffuse abdominal pain associated with alteration of general state. Clinical examination showed severe malnutrition and medium-volume ascites. Imaging tests (chest X-ray, ultrasound and computed tomography (CT) scan) showed multiple lung, liver, pancreatic, bone, lymph nodes and colic lesions suggesting multimetastatic tumor. Colonoscopy then showed budding lesion of the cecum. GeneXpert test showed Koch´s bacilli. The anatomo-pathological examination of colic biopsies and GeneXpert sputum test confirmed multifocal tuberculosis. The patient received antituberculosis treatment and nutritional support. However he died. Multifocal tuberculosis is a serious disease that is difficult to diagnose. Then it is frequently mis-diagnosed in tropical areas, especially when it occurs in immunocompetent patients.

Guided growth vs.Tibial osteotomy at early stage of Blount disease in squelletically immature patients.

BACKGROUND: There are no comparative study between guided growth and tibial osteotomy in early stage of Blount disease (BD) to our knowledge. The aim of this work was to compare the results of patients treated by these two techniques. METHOD: This was a retrospective, descriptive, and analytical study over a period of 5 years in including 17 children (24 Knees) with an early stage of infantile BD in two centers. Patient were classified in two groups: group 1(treated by guided growth), group 2 (treated by Tibial Osteotomy).Preoperative alignment analysis using the tibial femoral angle (HKA) and the proximal medial tibial mechanical angle (mMPTA) were compared with three measurements taken postoperatively in each of the groups. The mean variations of the angles were compared between the two groups. RESULTS: Socio-demographic characteristics were similar for the two groups. Median age at surgery was 6.5 ± 2.5 [3-9 years] in group 1 and 6.8 ± 2.9 years [3-9 years]. At a follow-up of 24 ± 3.5 months, the limb alignment was significantly corrected (1,03°/month) in group 1 (median HKA 144°-171°; p = 0,001; median MMPTA 78°-87°, p = 0,018), and in group 2 we observed at a follow-up of 23 ± 15 months a progressive loss (0,52°/month) of the correction obtained immediately postoperatively (median HKA 160°-176°(immediate post operative) to 165,5°; p = 0,31; median MMPTA = 78°-86° (immediate post operative) to 80,5°; p = 0,37).There was a statistically significant difference between the mean variation in HKA between the two groups (group 1 = 22,5; group 2 = 4,5, p = 0.00), as well as for MMPTA; (group 1 = 7; group 2 = 2,5, p = 0,023).The rate of correction was 78% in group 1 with no rebound at a median follow-up after removal of the material of 10 ± 2.4 months. Within group 2, the rate of correction was 10% with a recurrence rate of 60%. CONCLUSION: Guided growth appears to be the best treatment for early stage of BD in squelletically immature patients.

[Rare location of tuberculosis: endometrial tuberculosis]. / Une localisation rare de la tuberculose: la tuberculose endométriale.

Tuberculosis is a public health problem, especially in the developing countries. Bacillary pulmonary tuberculosis is the most common form of tuberculosis while genital tuberculosis is rare and underdiagnosed. We here report a case of endometrial tuberculosis. The study involved a 72-year old female patient with SC hemoglobinopathy consulting her gynecologist because of chronic leukorrhea. Cytobacteriologic assessment of vaginal swabs showed Streptococcus agalactatiae. Despite suitable antibiotic therapy, the evolution was marked by the persistence of leukorrhea. Pelvic ultrasonography objectified thickened endometrium, appearing as hyperechoic at the base of the uterus. This was suggestive of endometrial cancer. Anatomo-pathological examination of endometrial curettage samples showed granulomatous endometritis suggesting follicular tuberculosis. Outcome was favorable under antituberculosis treatment. In TB endemic areas, genital tuberculosis is not exceptional and should be suspected in patients with chronic leukorrhea despite suitable treatment.

[Mistreatment of students and associated factors in the Faculty of Medicine of Parakou in 2018]. / Maltraitance des étudiants et facteurs associés à la Faculté de Médecine de Parakou en 2018.

INTRODUCTION: Several studies around the world have shown a significant increase in student mistreatments in the Faculty of Medicine. The purpose of our study was to analyze student mistreatments and associated factors in the Faculty of Medicine of the University of Parakou (FM/UP) in 2018. METHODS: We conducted a cross-sectional, descriptive and analytical survey among the students of the Faculty of Medicine of the University of Parakou from 1st to 28 February 2018. Participants were second-year medical students (PCEM2), fourth-year medical students (DCEM2) and sixth-year medical students (DCEM4) attending the academic year 2017-2018 and who had freely given their informed consent to participate in the study. RESULTS: One hundred percent of students of the FM/UP had experienced mistreatment at least once. Students had frequently experienced mistreatment in 34.34% of cases. Humiliation, verbal violence and instigation to personal services were the most common types of violence. However, approximately 10% of students had experienced sexual harassment. Perpetrators of mistreatments were doctors/teachers, nurses and interns. Female students were three times more sexually harassed than their colleagues of the opposite sex (p=0.0069). The older the students were and enrolled in the second-year of the Faculty of Medicine, the more they experienced humiliation (p=0.0001 for age and p<0.0001 for education) and verbal violence (p=0.0007 for age and p<0.0001 for education). CONCLUSION: This study highlights that all the students of the FM/UP have experienced mistreatment at least once after enrolment in the university. Based on this study, university officials should implement communication strategies to change the abusive behavior of teachers and supervisors. A register of complaints would also be useful in reducing this phenomenon.

Profil à l'imagerie par résonnance magnétique (IRM) des lésions traumatiques du genou avec radiographie normale

Objectifs : A travers cette étude, nous envisageons effectuer un panorama des lésions découvertes à l'IRM chez les traumatisés du genou à radiographie standard normale. Matériels et méthode : Etude descriptive transversale réalisée sur une période de 28 mois portant sur 211 patients traumatisés du genou ayant une radiographie standard normale, adressés pour une IRM du genou. Résultats : Sur les 211 dossiers, nous avons colligés 80 cas de lésions soit 38,1% avec une prédominance masculine (sex ratio 1,6). Les atteintes rencontrées par ordre de fréquence étaient : méniscales (55,9%), ligaments croisés (37%), ligaments collatéraux (18%), rétinacula (13%), appareil extenseur (8,6%), contusion osseuse (20%) ; épanchement articulaire (66,7). Ces lésions étaient dominées par des lésions du compartiment médial du genou avec en chef de file l'atteinte du ménisque médial suivi des atteintes du LCA. Les atteintes du ménisque médial sont souvent aussi associées à celles du ligament collatéral médial (LCM). Conclusion : Au terme de ce travail, nous pouvons affirmer que l'IRM a permis de déterminer un nombre non négligeable de lésions ménisco-ligamentaires et osseuses non visibles en radiographie standard montrant les limites de cette dernière