[The problem of oculo-orbital trauma due to motor vehicle accidents involving commercial motorbikes in Douala, Cameroon]. / Les traumatismes oculo-orbitaires dus aux accidents de motos taxis à Douala au Cameroun.

UNLABELLED: A prospective and longitudinal study was carried from January 2 to December 31, 2013 in which victims of commercial motor bike accidents presenting to the Laquintinie Hospital in Douala were examined in search of oculo-orbital injuries with the double goal of identifying and evaluating the physical impact of the observed oculo-orbital lesions. RESULTS: We included 88 cases with oculo-orbital trauma due to commercial motor bike accident. There were 71 males (80.7%) and 17 females (19.3%). The mean age was 32.8±10.6 years. Collision between two motorbikes was the most frequent mechanism and accounted for 42% of cases of oculo-orbital trauma (n=37). None of the 81 patients on a motor bike reported wearing a helmet at the time of the accident (7 pedestrians were victims). Injuries of the globe were present in 16.5% of eyes (n=29); while orbital injuries were present in 22% of eyes (n=39). The most frequent orbital injury was orbital wall fracture, occurring in 31 eyes (17.6%). Lesions of the eyelids were found in 50 cases (28.4%). ENT lesions were associated in 27 cases (30.7%), cranial trauma in 3 cases (3.4%). Orbital dystopia, oculomotor palsy, ptosis, ectropion and unilateral blindness (rate of 9%) were sequelae recorded after six months of follow-up. CONCLUSION: The existing rules and regulations on driving licenses, vehicle code and compulsory use of helmets in the area of commercial motorbike activity should be strictly applied in Douala to avoid these preventable oculo-orbital trauma which lead to unsightly scars and blindness.

Ocular injuries in female victims of domestic violence in Brazzaville (Congo)

Objective. In the traditional African society, the social status of women remains precarious. The spouse who has ''spent money to acquire'' a woman often claims to have''every right over her''. In some cases the woman is subjected to abuse that can lead to death. The aim of the study was to describe ocular injuries in women who were victims of domestic violence in Brazzaville. Design. Cross-sectional study conducted at the University Hospital of Brazzaville between January 2013 and December 2014 (2 years). Data was obtained using a questionnaire sheet. The following parameters were analyzed: age and level of education of spouses (below or above university) reason of dispute, mechanism of trauma and observed lesions. Subjects. Women admitted for an ocular injury that could jeopardize the visual and or vital prognosis (involvement of another vital organ during the same trauma) due to an incidence of domestic violence. Results. The study included a total of 15 women (and their corresponding 15 spouses). The average age of men and women was respectively 55 ± 10 and 35 ± 13 years. 73.33% of men had higher level of education compared to 53.33% of women. The main reasons of violence were jealousy (46.67%) and finance disputes (26.67%). The main mechanism of injury was a fist punch (80.00%), meanwhile, the major lesions observed were: bursting of the eyeball (40.00%) and fracture of the orbital floor (26.67%). Conclusion. In Brazzaville, domestic violence is responsible for ocular injuries leading to irreversible blindness

Glaucome néovasculaire: étiologies et difficultés liées à sa prise en charge à Brazzaville

INTRODUCTION: Le glaucome neovasculaire (GNV) est lie a une neovascularisation de l'angle iridocorneen secondaire a une hypoxie prolongee de la retine. Dans les pays occidentaux; son traitement est bien codifie et le pronostic est bien meilleur qu'a Brazzaville ou le GNV se termine souvent par une enucleation suite a une phtise hyperalgique ou a un eclatement spontane de l'oil. OBJECTIF: enumerer les principales etiologies du GNV et discuter des difficultes liees a sa prise en charge a Brazzaville. MATeRIELS ET MeTHODES: etude transversale; multicentrique (CHU/Brazzaville; Clinique Medicale de Brazzaville); realisee sur une periode de 7 ans sur la base de dossiers de patients vus pour un GNV. Le GNV etait defini par l'association d'une rubeose irienne et d'un tonus oculaire superieure a 21 mm Hg. Les parametres suivant etaient analyses: motifs de consultation; presentations cliniques; etiologies et traitements.ReSULTATS : 25 dossiers ont ete retenus (correspondant a 30 yeux souffrant de GNV). La douleur oculaire etait le principal motif de consultation (92%; 23/25 patients). La cornee etait opaque avec gonoscopie et fond d'oeil impossibles dans 83;33% des cas (25/30 yeux). Les etiologies etaient: diabete sucre (88%; 22/25 patients); occlusion de la veine centrale de la retine (12%; 3/25 patients). Perdus de vue 7/25 patients correspondant a 7/30 yeux. Le traitement consistait en enucleation (69;56%; 16/23 yeux); photocoagulation retinienne (21;74%; 5/23 yeux); et injection retrobulbaire de Chlorpromazine (8;70%; 2/23 yeux). CONCLUSION: Le diabete sucre est la principale etiologie du GNV a Brazzaville. Le manque de moyens techniques et les consultations tardives n'offrent que peu d'alternative therapeutique a l'enucleation qui reste largement malheureusement utilisee

Clarithromycin suppresses bronchial hyperresponsiveness associated with eosinophilic inflammation in patients with asthma.

BACKGROUND: Although long-term administration of 14-membered macrolide antibiotics is a therapeutic alternative in asthma, both its pharmacologic mechanism of action and association with the pathogenesis of asthma remain obscure. OBJECTIVE: This study investigated the suppressive effect of clarithromycin on airway responsiveness to methacholine provocation testing and examined whether chrarithromycin's antiasthmatic activity is associated with a reduction in eosinophilic inflammation. METHODS: For 8 weeks, patients received 200 mg of clarithromycin or identical-appearing placebo twice daily. We assessed the effects of treatment with clarithromycin on bronchoconstriction precipitated by inhalation of methacholine in 17 adults with mild or moderate bronchial asthma who were in stable clinical condition. A double-blind, randomized, crossover design was used. Eosinophil counts and eosinophilic cationic protein (ECP) levels were determined in blood and sputum samples obtained on the morning of the methacholine provocation testing day. RESULTS: After 8 weeks of treatment with clarithromycin, patients' symptoms, blood and sputum eosinophils counts and sputum ECP levels were significantly decreased compared with both placebo and baseline. Furthermore, values of PC20 methacholine improved in all patients after clarithromycin treatment. CONCLUSIONS: Clarithromycin has a bronchial anti-inflammatory effect associated with decreased eosinophilic infiltration. This study suggests interesting therapeutic possibilities for bronchial asthma that warrant further trials.