Evidence of natural infections with Trypanosoma, Anaplasma and Babesia spp. in military livestock from Tunisia.

Livestock constitute habitual hosts and carriers for several infectious pathogens which may represent a serious public health concern affecting the readiness of military forces and lead to wide economic losses. The present report aimed to investigate the prevalence of some haemopathogens infecting military livestock, particularly, dromedaries, sheep and horses using Giemsa-stained blood smears. A total of 300 animals (100 from each species) were selected, clinically examined and sampled. Trypanosoma spp. (22.0%), Anaplasma spp. (17.0%) and Babesia spp. (1.0%) were identified in camels' blood. Six dromedaries were found to be co-infected by Trypanosoma and Anaplasma organisms (6.0%). Camels of female gender, infested by ticks and showing clinical signs were statistically more infected by Trypanosoma spp., compared to those of male gender, free of ticks and apparently healthy (P= 0.027, 0.000 and 0.004, respectively). Babesia spp. infection (1.0%) was identified, for the first time in Tunisia, in one adult female camel that presented abortion and anemia. Anaplasma spp. was the only haemopathogen identified in examined sheep (6.0%) and horses (17.0%). Horses infested by Hippobosca equina flies and sheep infested by Rhipicephalus turanicus ticks were more infected by Anaplasma spp. than other non-infested animals (P=0.046 and 0.042, respectively). Hyalomma dromedarii, H. impeltatum and H. excavatum were the most prevalent diagnosed ticks removed from camels with an intensity of infestation of 1.2 ticks per animal. However, in sheep, only R. turanicus was identified. H. equina and Tabanus spp. were the potential hematophagous flies found in dromedaries and horses herds. This useful data must be taken into consideration during animal treatment and vectors' control programs in Tunisian military farms which help to limit the diffusion of vector-borne diseases, keep our livestock healthy and reduce economic losses.

Evidence of natural infections with Trypanosoma, Anaplasma and Babesia spp. in military livestock from Tunisia

@#Livestock constitute habitual hosts and carriers for several infectious pathogens which may represent a serious public health concern affecting the readiness of military forces and lead to wide economic losses. The present report aimed to investigate the prevalence of some haemopathogens infecting military livestock, particularly, dromedaries, sheep and horses using Giemsa-stained blood smears. A total of 300 animals (100 from each species) were selected, clinically examined and sampled. Trypanosoma spp. (22.0%), Anaplasma spp. (17.0%) and Babesia spp. (1.0%) were identified in camels’ blood. Six dromedaries were found to be co-infected by Trypanosoma and Anaplasma organisms (6.0%). Camels of female gender, infested by ticks and showing clinical signs were statistically more infected by Trypanosoma spp., compared to those of male gender, free of ticks and apparently healthy (P= 0.027, 0.000 and 0.004, respectively). Babesia spp. infection (1.0%) was identified, for the first time in Tunisia, in one adult female camel that presented abortion and anemia. Anaplasma spp. was the only haemopathogen identified in examined sheep (6.0%) and horses (17.0%). Horses infested by Hippobosca equina flies and sheep infested by Rhipicephalus turanicus ticks were more infected by Anaplasma spp. than other non-infested animals (P=0.046 and 0.042, respectively). Hyalomma dromedarii, H. impeltatum and H. excavatum were the most prevalent diagnosed ticks removed from camels with an intensity of infestation of 1.2 ticks per animal. However, in sheep, only R. turanicus was identified. H. equina and Tabanus spp. were the potential hematophagous flies found in dromedaries and horses herds. This useful data must be taken into consideration during animal treatment and vectors’ control programs in Tunisian military farms which help to limit the diffusion of vector-borne diseases, keep our livestock healthy and reduce economic losses.

Les perforations pharyngo-oesophagiennes par corps étranger

Introduction : La perforation pharyngo-œsophagienne par ingestion de corps étranger (CE) est une complication rare et grave. De ce fait, sa prise en charge n'est pas standardisée. Le but de ce travail est d'étudier les caractéristiques épidémiologiques et diagnostiques de ces complications et de discuter les modalités thérapeutiques. Patients et méthodes :Sur une période 17 ans (1998 - 2014), nous avons colligé 573 patients ayant ingéré des CE pharyngo-œsophagiens et qui ont bénéficié d'une extraction endoscopique au tube rigide. Onze patients (1,9%) se sont compliqués d'une perforation. Résultats : Il s'agissait de 3 enfants et 8 adultes. Les corps étrangers étaient dominés par les fragments d'os (55% des cas). Les perforations étaient jugées liées aux manœuvres d'extraction dans 54,5% et au CE dans 45,5%. Le diagnostic a été posé dans un délai maximal de 2 jours après extraction. La chirurgie a été réalisée d'emblée dans 2 cas devant la migration extra-viscérale du CE et devant la présence d'une abcédation péri-œsophagienne, respectivement. Le geste opératoire consistait, respectivement, en l'ablation du CE avec suture de l'œsophage et un simple drainage de l'abcès. Dans un autre cas, la chirurgie a été pratiquée en seconde intention après échec du traitement médical et devant l'apparition d'une pleurésie purulente. Le geste opératoire était une suture renforcée par un lambeau intercostal. Un traitement conservateur était instauré dans 8 cas (72,7%).L'évolution était favorable dans 10 cas (soit 90,9%) et fatale dans un seul cas, soit une mortalité de 9,1%. Conclusion : Le pronostic dépend essentiellement de la précocité diagnostique des perforations œsophagiennes par CE. Le traitement conservateur serait suffisant et efficace en dehors d'un syndrome infectieux sévère

Ileal pouch-anal anastomosis: Points of controversy.

Restorative proctocolectomy with ileal pouch-anal anastomosis has become the most commonly used procedure for elective treatment of patients with ulcerative colitis and familial adenomatous polyposis. Since its original description, the procedure has been modified in order to obtain optimal functional results with low morbidity and mortality, and yet provide a cure for the disease. In this review of the literature of restorative proctocolectomy with ileal pouch-anal anastomosis, we discuss these technical modifications, limiting our discussion to the current points of controversy. The current "hot topics" for debate are: indications for ileal pouch-anal or ileo-rectal anastomosis, indications for pouch surgery in the elderly, indeterminate colitis and Crohn's disease, the place of the laparoscopic approach, transanal mucosectomy with hand-sewn anastomosis vs. the double-stapled technique, the use of diverting ileostomy and the issue of the best route for delivery of pregnant women. Longer follow-up of patients and increased knowledge and experience with pouch surgery, coupled with ongoing prospective evaluation of the procedure are required to settle these issues.

[Rectal stromal tumor: about a case]. / Tumeur stromale rectale: à propos d'une observation.

Gastro-intestinal stromal tumors are uncommon mesenchymal tumors. There are localized preferentially in the stomach. The rectal localization is exceedingly rare. Through a new case of rectal stromal tumour as well as a review of the literature, we propose to focus on clinical, radiological and therapeutic particularities of this rare entity.

Duodenal diverticulum associated with annular pancreas: a rare cause of severe cholangitis.

Duodenal diverticulum is a common occurrence but most are asymptomatic. However, in some cases, they can cause mechanical biliary compression. We report the case of a duodenal diverticulum in a 64-year-old woman revealed by severe cholangitis with septic shock and a liver abscess. Associated annular pancreas was found. We discuss the various investigations to diagnose these two entities as well as the therapeutic strategy in this unique combination of disease.

[Megalencephalic leukoencephalopathy with subcortical cysts: report of 4 new cases]. / La leucoencéphalopathie mégalencéphalique avec kystes sous-corticaux: description de 4 nouveaux cas.

Megalencephalic leukoencephalopathy with subcortical cysts or Van der Knapp disease is a rare entity that has recently been identified. It is characterized by the presence of macrocephaly, epilepsy and a slowly progressive spastic cerebellar syndrome. The culprit MLC1 gene is located on chromosome 22. MRI provides valuable data for diagnosis characterized by diffuse white matter lesions with subcortical cysts. We report four cases of megalencephalic leukoencephalopathy with subcortical cysts from two different families.

[Cardiotoxicity of n-methyl-glucamine antimoniate (Glucantime). A case report]. / Toxicité cardiaque de l'antimoniate de méglumine (Glucantime). A propos d'une observation.

The pentavalent antimonial meglumine (Glucantime) is the drug of choice in treatment of cutaneous leishmaniasis in Tunisia. It may create severe adverse effects. A ten year-old girl was treated by Glucantime for cutaneous leishmaniasis. On the eighth day of treatment, she developed palpitations and precordialgia. The ECG showed T wave inversion prolongation of corrected QT interval. Drug therapy was stopped. Within a few days, she recovered and her elctrocardiographic changes came back to normal. The cardio toxicity of Glucantime may be severe. Electrocardiographic changes are the primary signs. Long term ECG follow-up is necessary.

[Antenatal bilateral sylvian infarction and congenital syphilis]. / Ramollissement sylvien bilatéral anténatal et syphilis congénitale.

BACKGROUND: The classical symptoms of congenital neurosyphilis include meningovascular lesions that are responsible for CSF abnormalities. Lesions of larger vessels are very unusual. CASE REPORT: A boy was born from a neglected pregnancy, weighing 2.7 kg. He was abandoned by his parents and was admitted to hospital at 40 days of age (weight: 2,220 g; height: 47 cm; head circumference: 22 cm) with axial hypotonia, peripheral spasticity and shock syndrome. The TORCH screen was negative but the Treponema Pallidium Hemagglutination Assay (TPHA) was positive. The infant died 4 days later. Brain pathological studies revealed meningoencephalitis and bilateral sylvian infarction. CONCLUSION: Local arteritis due to syphilis usually concerns small arteries, such as the meningeal and cortical vessels. The occlusion of the two middle cerebral arteries seen in this patient, which were responsible for atrophy of the parietal lobes, is uncommon in congenital syphilis.

[Cardiac manifestations of sickle cell disease]. / Les manifestations cardiaques de la drépanocytose.

In this study the authors report the cardiac complications seen in the course of sickle-cell disease. Among 41 homozygot patients the complications reported were as follow. Effort dyspnea in 15/32 (46% cases); systolic souffle in 36 patients (87.8% of cases); cardiomegaly in 30 patients (17% of cases) and electric abnormalities in 70% of cases. The echotomography practised in 27 cases was normal in 12 cases and showed a hyperkinetic aspect in 10 cases, a cardiomyopathy in four cases.