Plant biomass and seed production of the legumes Aeschynomeme histrix and Stylosanthes hamata and the potential of endozoochory by cattle and sheep in semi-arid native pastures.

Endozoochory is a substantial vector for seed dispersal and plays an important role in vegetation dynamics, mainly in colonisation processes through seed input to the vegetation and soil seed bank. We investigated the endozoochorous seed input by cattle and sheep on a pasture located in the western region of Burkina Faso. Through germination experiments, we assessed viable seed content of the dung of these grazing animals to estimate their suitability and efficiency for seed dispersal of fodder legumes. Cattle and sheep were daily fed seeds of Sthylosanthes hamata and Aeschynomene histrix, mixed with cotton seed cake. Faeces containing seeds of both legumes were collected 24 h after feeding. One part of faeces samples was spread in buckets of soil for direct germination in the greenhouse to evaluate germinating seed content. To improve pastures, a randomized completed design with 6 replications was conducted with both legumes and phosphorus fertilization (0 and 100 kg/ha of P2O5) and year as experimental factors. Recovery of A. histrix seeds was better than that of S. hamata with cattle (18 and 9%, respectively) compared to sheep. Seed recovered from faeces had higher germination with sheep than cattle. Thus, S. hamata seed recovered from faeces germinated well (12 and 45% with cattle and sheep, respectively, than fresh seeds used as control. However, A. histrix's seeds recovered from faeces germinated less than control (P < 0.001). The findings confirmed that ruminants could be used for targeted legume seed dispersal in natural pastures. A. histrix and S. hamata have high potential for plant biomass and seed production when phosphorus is applied. Seed ingestion by ruminants should be undertaken for improving natural pastures in semi-arid zones as lower cost practice.

Characteristics of obstetric urogenital fistulas in a regional teaching hospital in Burkina Faso: a retrospective cross-sectional study.

Introduction: Obstetric fistula (OF) remains a major public health problem in low-income countries. This study aimed to investigate the sociodemographic, clinical, and therapeutic characteristics of obstetric urogenital fistulas in a regional teaching hospital in Burkina Faso. Methods: a retrospective cross-sectional study from 1st January 2015 to 31st December 2019 included 50 women who underwent OF surgery repair in the regional teaching hospital of Ouahigouya in Burkina Faso. Case identification was completed by self-reported constant urine leakage and was confirmed by clinical assessment. Data on socio-demographic, clinical, and therapeutic characteristics have been collected from the hospital medical records and analyzed. Results: the mean age of the patients was 29.40 ± 9.4 years (range 15 -55 years). The majority of patients were in the age group between (15-25) years old (44%). Forty-three patients (86%) were residing in rural areas and forty-seven patients (94%) were housekeepers. Twenty-six patients (52%) were primiparous. The majority of patients had received no prenatal care 29 (58%). The majority of patients had a spontaneous vaginal delivery 36 (72%). The duration of labor was greater than 48 hours in 31 (62%) patients. Vesicovaginal fistulas (VVF) accounted for 80% of cases. Ten (20%) patients had previously undergone surgery for the same fistula. The mean size of the fistulas was 1.8±1.4 cm (range 0.5 - 6 cm). At three months of follow-up, the successful closure rate was 68%. Sixteen (32%) patients have experienced a failure of fistula closure. Conclusion: the majority of fistula survivors were women of reproductive age who were living in rural areas and housekeepers. Mothers having no antenatal care, and having prolonged labor were at increased risk of developing OF. The majority of fistulas were simple fistulas and the most common type of OF was VVF. Surgical outcomes showed a high failure rate.

[Abdomen Trauma From A Fall From A Height In Two University Teaching Hospital In Burkina Faso]. / Traumatismes De l'Abdomen Par Chute De Hauteur Dans Deux Centres Hospitaliers Universitaires Du Burkina Faso.

PURPOSE: The purpose of this study was to describe the nature and reasons for the fall, the injuries caused and their prognosis. PATIENTS AND METHODS: This was a descriptive cross-sectional study over a period of 9 years. Patients admitted for abdominal trauma from a fall from a height during the study period were included. Ultrasound and CT scan allowed diagnosis of the lesion. Patients in shock who do not respond to resuscitation are considered to have unstable hemodynamics. RESULTS: fifty-three cases of abdominal trauma by falling from a height, including 11 adults and 42 children, were collected. They were 46 men and 7 women. The average age was 11.6 years. In 86.8% (n=46) of the cases it was a fall from the top of a tree. There were 83% (n=44) abdominal contusion and 17% (n=9) open trauma. Other lesions were associated in 28.3% (n=15) of cases. There were 26 splenic lesions (49%), 14 liver (22.6%) and 6 hollow organs (11.3%). Non-operative treatment was applied in 79.2% (n=42) of cases. Morbidity was 9.4% (n=5) and mortality 5.7% (n=3). CONCLUSION: Abdominal trauma from a fall from a height was dominated by falls from the top of fruit trees, and occurred in young male subjects.

BUT: Le but de cette étude était de décrire la nature et les raisons de la chute, les lésions engendrées et leur pronostic. PATIENTS ET MÉTHODES: il s'est agi d'une étude transversale descriptive sur une période de 9 ans. Les patients admis pour traumatisme abdominal par chute de hauteur au cours de la période d'étude ont été inclus. L'échographie et le scanner ont permis de poser le diagnostic lésionnel. Les patients en état de choc ne répondant pas à la réanimation ont été considérés à hémodynamie instable. RÉSULTATS: cinquante-trois cas de traumatisme abdominal par chute de hauteur dont 11 adulteset42 enfants, ont été colligés. Il s'agissait de 46 hommes et de 7 femmes. L'âge moyen était de 11,6 ans. Dans 86,8% (n=46) des cas il s'agissait d'une chute du haut d'un arbre. Il y avait83%(n=44) de contusion abdominale et 17% (n=9) de traumatisme ouvert. D'autres lésions étaient associées dans 28,3% (n=15) des cas. Il y avait 26 lésions spléniques (49%), 14 hépatiques (22,6%) et 6 d'organes creux (11,3%). Le traitement non opératoire avait été appliqué dans 79,2% (n=42) des cas. La morbidité était de 9,4% (n=5) et la mortalité de 5,7% (n=3). CONCLUSION: Les traumatismes de l'abdomen par chute de hauteur étaient dominés par les chutes du haut d'arbres fruitiers, et étaient le fait des sujets jeunes de sexe masculin.

[Biliary peritonitis: diagnostic and therapeutic aspects]. / Les péritonites biliaires : aspects diagnostiques et thérapeutiques.

AIMS: The aim was to describe the diagnostic and therapeutic aspects of biliary peritonitis. PATIENTS AND METHODS: This was a descriptive cross-sectional study with retrospective collection over a period of 10 years including patients operated on for biliary peritonitis. RESULTS: We collected 10 cases of biliary peritonitis with an average age of 38 years with a sex ratio of 2.3. Two patients presented with an abdominal contusion following a road traffic accident. Maximum abdominal pain in the right hypochondrium was present in three patients, signs of peritoneal irritation in all patients, positive Widal and Felix serodiagnosis in eight patients. At midline laparotomy, the gallbladder was perforated in three patients, gangrenous in five, phlegmonous in one, sclero-atrophic in one. Cholecystectomy was performed in all patients. Biliary peritonitis was of traumatic origin in two patients, and typhoid in eight. Postoperatively, there were four cases of sepsis and three cases of parietal suppuration. Three patients died. CONCLUSION: Biliary peritonitis discovered during laparotomies for peritonitis, was secondary to typhoid cholecystitis, and had a high morbidity and mortality.

BUTS: Le but était de décrire les aspects diagnostiques et thérapeutiques des péritonites biliaires. PATIENTS ET MÉTHODES: Il s'est agi d'une étude transversale descriptive à collecte rétrospective sur une période de 10 ans incluant les patients opérés pour péritonite biliaire. RÉSULTATS: Nous avons colligé 10 cas de péritonite biliaire d'un 'âge moyen de 38 ans avec un sex-ratio de 2,3. Deux patients présentaient une contusion abdominale par suite d'un accident de la circulation routière. Une douleur abdominale maximale à l'hypochondre droit était présente chez trois patients, des signes d'irritation péritonéale chez tous les patients, un sérodiagnostic de Widal et Félix positif chez huit patients. À la laparotomie médiane la vésicule biliaire était perforée chez trois patients, gangrénée chez cinq, phlegmoneuse chez un, scléro-atrophique chez un. La cholécystectomie a été réalisée chez tous les patients. La péritonite biliaire était d'origine traumatique chez deux patients, et typhique chez huit. En post opératoire on notait quatre cas de sepsis, et trois cas de suppuration pariétale. Trois patients sont décédés. CONCLUSION: les péritonites biliaires découvertes lors de laparotomies pour péritonite, étaient secondaires à des cholécystites typhiques, et avaient une forte morbi-mortalité.

Cancers primitifs de l'intestin grêle: épidémiologie, diagnostic et traitement dans un contexte de ressources limitées / Primitive Cancers of small Intestine: Epidemiology, diagnosis and treatment in a context of limited resources

Contexte et objectif. Le but de cette étude était d'étudier les aspects épidémiologiques, histologiques et thérapeutiques des cancers primitifs du grêle. Méthodes. Il s'est agi d'uneétude transversale à visée descriptive sur 10 ans et incluant tous les patients traités pour cancers primitifs de l'intestin grêle. La collecte des données a été rétrospective. Le test de Khi 2 a été utilisé pour la comparaison des données avec un seuil de signifi cation de 5%. Résultats. Cinquante-quatre dossiers de patients ont inclus dans l'étude dont 33 patients de sexe féminin (61,1%). L'âge moyen était de 34,3 ans. Trente-deux patients (59,3 %) ont été admis dans un tableau d'urgence chirurgicale, soit 24 occlusions intestinales aiguës et 8 péritonites aiguës généralisées. Les autres patients ont été admis dans un contexte de masse abdominale douloureuse. Le cancer était localisé sur l'iléon dans 27 cas (50%), sur le jéjunum dans 11 cas (20,3%) et sur le duodénum dans 16 (29,7%) cas. L'adénocarcinome était le type histologique le plus fréquent (35,2%), suivi des tumeurs endocrines (33,3%). Un envahissement local ou métastatique était noté chez 46 patients (85,2%) au moment du diagnostic. Une résection - anastomose a été réalisée dans 29 cas (53,7%) et une dérivation interne dans 19 cas (35,3%). La survie à 1 an était de 70%. Conclusion. Les cancers primitifs de l'intestin grêle sont souvent des adénocarcinomes.Ils surviennent chez des patients jeunesavec une prédominance des localisations iléales.

Reduction of Neglected Displaced Fractures of the Distal Femoral Physis.

BACKGROUND: We performed open osteoclasis, soft-tissue release, and fracture fragment reduction and fixation to treat 10 cases of neglected physeal fractures of the distal aspect of the femur with severe deformity. To our knowledge, no specific surgical procedure for this problem has been reported in the literature. DESCRIPTION: The procedure is typically performed through an extensile anterolateral approach. With use of an osteotome, the typically abundant fracture callus is disrupted and partially removed to recreate the original fracture line. Through periosteal dissection, an extensive musculoperiosteal detachment and release is achieved to facilitate fracture reduction while protecting the physis from further injury. ALTERNATIVES: Knee rehabilitation in closed, nondisplaced or minimally displaced fractures1.Open callus osteoclasis in combination with a Z-shaped quadriceps tenoplasty, reduction, and plaster cast immobilization2.Open subperiosteal osteoclasis, reduction, and tibial traction3.Open callus osteoclasis, reduction, and condylar plating4.Sequestrectomy with preservation of a periosteal sleeve to treat osteomyelitis complicating an open fracture1.Transfemoral amputation to treat gas gangrene or vascular injury following severe open injury1,5-7. RATIONALE: This procedure was developed in remote medical facilities where patients are often first seen >21 days after the original injury. By that time, closed reduction or standard open reduction and internal fixation techniques are no longer possible. After 6 months of fracture age, the procedure is inefficient. EXPECTED OUTCOMES: This procedure allows correction of limb malalignment and shortening while preserving the growth plate1. IMPORTANT TIPS: In some cases, hypertrophic fracture callus might be mistaken for the femoral diaphysis.An extensive musculoperiosteal release will facilitate reduction of the fracture fragments.The adequacy of reduction must be assessed in all 3 planes intraoperatively.The adequacy of reduction must be assessed in all 3 planes intraoperatively.The adequacy of reduction must be assessed in all 3 planes intraoperatively.

[Total hip replacements in a country with limited resources: evaluation of medium-term results]. / Arthroplasties totales de hanche dans un pays a ressources limitees : evaluation des resultats a moyen terme.

INTRODUCTION: Total hip arthroplasty (THA) has been regularly performed in the public hospital in Bobo-Dioulasso since 2010. The objective of thisstudywas to assess the medium-termresults of total hip arthroplastyat the Bobo-Dioulasso UniversityHospital. Dioulasso. PATIENTS AND METHODS: This was a non-randomized single-center retrospectivestudydesigned in accordance with the recommendations of the Declaration of Helsinki. Wereviewed the medical files and evaluated 29 patients, i.e. 33 hipsoperated for THA at the Bobo-Dioulasso UniversityHospitalfromJanuary 1st, 2010 to December 31, 2015. RESULTS: ONATF was the indication for ATH in 78.79% of cases (n = 28). THA wascementedin 43% of cases. Complications wereposterior dislocations (n = 4), infection (n = 1) and loosening (n = 2). The meanfollow-up was 78.3 months. At the last follow-up, the mean PMA was 15.13 and the mean Harris score was 84.36. The inclination of the cupswasbetween 45 ° and 50 °. The femoral stems werecenteredin 94% of cases (n = 32). There was one case of peri-prosthetic ossification and one case of acetabularrim. CONCLUSION: Total hip arthroplasty has become a common and well-codified practice in orthopedicsurgerywithreliable and veryencouragingresults.

INTRODUCTION: L'arthroplastie totale de la hanche (ATH) est régulièrement pratiquée dans l'hôpital public à Bobo-Dioulasso depuis 2010. L'objectif de cette étude était d'évaluer les résultats à moyen terme des arthroplasties totales de hanches au CHU de Bobo-Dioulasso. PATIENTS ET MÉTHODES: Il s'agissait d'une étude rétrospective monocentrique non randomisée rédigée conformément aux recommandations de la déclaration d'Helsinki. Nous avons revu les dossiers médicaux et évaluer 29 patients soit 33 hanches opérées pour PTH au CHU de Bobo-Dioulasso du 1er Janvier 2010 au 31 Décembre 2015. RÉSULTATS: L'ONATF était l'indication de l'ATH dans 78,79% des cas (n=28). Les PTH étaient cimentées (n=14) ou non. Les complications étaient les luxations postérieures (n=4), l'infection (n=1) et le descellement (n=2). Le recul moyen était de 78,3 mois. Au dernier recul, le PMA moyen était de 15,13 et le score de Harris moyen de 84,36. L'inclinaison des cupules était comprise entre 45° et 50°. Les tiges fémorales étaient centrées 94% des cas (n=32). Il a été noté un cas d'ossification péri prothétique et un cas de liséré acétabulaire. CONCLUSION: L'arthroplastie totale de hanche est devenue une pratique courante et bien codifiée en chirurgie orthopédique avec des résultats fiables et très encourageants.

Surgical Site Infection after Digestive Surgery: Diagnosis and Treatment in a Context of Limited Resources.

Background: Surgical site infections (SSIs) are responsible for substantial morbidity in patients who undergo digestive surgery. However, very little is known about the aspects of SSIs in sub-Saharan Africa. Methods: The purpose of this study was to assess the prevalence and identify the risk factors of SSI in patients who were treated in the Department of Digestive Surgery of Tenkodogo Hospital in Burkina Faso. We performed a prospective study from January 1, 2016 to December 31, 2016. All patients who underwent digestive tract surgery during this period were included and followed. Patients whose post-operative surgical sites were complicated by infection were identified. Surgical site infection was diagnosed according to the U.S. Centers for Disease Control and Prevention (CDC) definition. Bacteriologic sampling was performed in all included patients. Results: A total 964 patients underwent surgery during the study period and were included in the study. Seven hundred thirty-seven were females (76.4%), and 227 were males. The mean age of the included patients was 47.5 years (standard deviation [SD] = 9 years). One hundred fourteen patients presented with SSI, the incidence of which was 11.8%. The incidence of SSI was substantially higher in females than in males (63.2 vs. 36.8%, p < 0.05). The incidence was also higher in patients living below the poverty line (71.1 vs. 28.9%, p < 0.05). Clinically, the incidence of SSI was higher in emergency surgery than in scheduled surgery (84.2 vs. 15.8%, p < 0.05). Contaminated or dirty surgery was more risky than clean surgery (p < 0.05). With respect to bacteria, the most commonly isolated microbes were Escherichia coli (66.7%) and Staphylococcus aureus (15%). Treatment mainly consisted of appropriate antibiotic therapy and local care. Three deaths were recorded for a mortality rate of 2.6%. Conclusions: Surgical site infections are frequent in sub-Saharan environments. The risk factors seem to be clinical and social.

[Epidemiology, treatment and prognosis of colorectal cancer in young adults in sub-Saharan Africa]. / Épidémiologie, traitement et pronostic du cancer colorectal de l'adulte jeune en milieu sub-saharien.

Colorectal cancer is the most common digestive cancer. The objectives of this study was to analyse the frequency, aetiologies, and the therapeutic and progressive aspects of colorectal cancer in young adults in Burkina Faso. This study was a 10-years descriptive study conducted in 2 regional hospitals in Burkina Faso. It included all patients aged 20 to 45 years admitted to these two hospitals for colon cancer or rectal cancer during the study period. A total of 116 patients were included, which was 39.2% of all patients admitted for colorectal cancer during the same period. The average age of the included patients was 35.4 years old. There were 70 male patients (60.3%). Seven patients had a history of chronic inflammatory bowel disease, and six had a family history of colon cancer. The average consultation time was 6.2 months. In 25 cases (19.9%), the cancer was discovered in the context of an abdominal emergency. Ninety-two patients (79.3%) were diagnosed at stage 3 or stage 4 according to the TNM Staging System. The most common histological type was adenocarcinoma (103 cases, 88.9%). Therapeutically, surgery was performed on 87 patients (75%) and chemotherapy was used in 37 cases (31.9%). Sixteen patients received radiotherapy. The intra operative mortality rate was 4.6%. The 5-year survival rate was 17%. In conclusion, colorectal cancer in young adults occurs without obvious risk factors in Burkina Faso. Mortality remains high because of the limited therapeutic arsenal.

[Primary urological cancers in a context of limited resources: Epidemiology and treatment]. / Les cancers urologiques primitifs dans un contexte de ressources limitées : épidémiologie et traitement.

OBJECTIVES: To describe the epidemiological, clinical and therapeutic aspects of primary urological cancers in semi-urban areas in Burkina Faso. PATIENTS AND METHOD: A descriptive study was conducted over the period from 1 January 2008 to 31 December 2017 in the General Surgery Department of the Tenkodogo Regional Hospital, located in the east of Burkina Faso. All patients over 15 years of age who were diagnosed with primary urological cancer were included. RESULTS: A total of 160 patients were included. One hundred and thirty-one patients were male (81.9%). The sex ratio was 4.5. The average age of the patients was 58.9 years (standard deviation: 18 years). We found 73 cases of prostate cancers (45.6%), 53 bladder cancers (33.1%), 17 kidney cancers (10.6%), 11 testicular cancers (6.9%) and 6 cancers of the male external genitalia (3.7%). The histological types of prostate cancer were adenocarcinoma (88%) and neuroendocrine carcinoma (12%). Thirty-seven prostate cancers (50.7%) were diagnosed at the T3 stage and 12 others (16.4%) at the T4 stage. Prostate cancer treatment was only medical in 23 patients; surgical treatment was indicated in 50 other patients. The 5-year survival was 85%. Sixteen patients (30.2%) had metastatic bladder cancer at the time of diagnosis. The treatment of vesical cancers has been palliative in 50 cases.

[Epidemiological, clinical, histological and therapeutic features of primary digestive cancers in Burkina Faso]. / Profil épidémiologique, clinique, histologique et thérapeutique des cancers digestifs primitifs dans les régions nord et est du Burkina Faso.

OBJECTIVE: To study the epidemiology and histology of primary digestive cancers in semi-urban areas in Burkina Faso. METHODS: This was a descriptive study over 5 years conducted simultaneously in 2 regional hospitals in Burkina Faso. It included all patients treated for primary digestive cancers. RESULTS: A total of 352 were included. The average age of the patients was 44.3 years. Patients aged between 30 and 49 years accounted for 44.6%. There were 175 male patients (49.7%). In the patient's history, we found 6 cases of ulcerative colitis, 2 cases of colonic adenoma, and 5 cases of hepatic cirrhosis. The average consultation time was 138 days. In 70 cases (19.9%), the cancer was discovered at a stage of complication. The most affected organs were the colon and rectum (36.7%), the stomach (21.9%) and the pancreas (19.0%). The most common histological type of cancer was adenocarcinoma (67.6%). One hundred and forty-four patients (40.9%) were diagnosed at stage 3 and 65 others (18.5%) at stage 4 of TMN staging. Therapeutically, surgery was used in 307 patients (87.2%) and chemotherapy in 63 cases (17.9%). The one-year mortality rate was 29%. CONCLUSION: In Burkina Faso rural area, primary digestive cancers occur in young patients with no predominance of sex. Colorectal cancer remains the most common.

Is Head and Neck Resection of the Femur (Girdlestone's Procedure) Still Relevant? Indications and Results About 24 Cases.

INTRODUCTION: Head and neck resection of the femur was described by Girdlestone in 1928 in the treatment of coxalgia. Very invasive at the beginning, this intervention is much less so today, but the term of "Girdlestone's operation" or "Girdlestone's procedure" has remained in use. The reported results are controversial. In resource-limited countries, Girdlestone's procedure is often indicated for lack of a better one. In this context, we report the results of a series of 24 patients operated in a regional hospital (Ouahigouya, Burkina Faso) with the aim of showing that this technique remains valid and can be benefit. METHODS: This was a retrospective descriptive study of 24 patients who had benefited from the procedure for cervical fracture sequelae, failure of arthroplasty or osteosynthesis, or osteonecrosis. All were operated by posterolateral approach, under spinal anesthesia and followed for 5 years with evaluation of the anatomical and functional results using the rating of Postel and Merle d'Aubigné (PMA). RESULTS: All patients had Trendelenburg lameness with a mean shortening of 3.5 cm. They were all autonomous with walking aids and the PMA score ranged from 16 to 14. Discussion: although the results obtained are not excellent, they are relatively good and have allowed all our patients to recover an acceptable autonomy, compatible with certain independence in everyday life. CONCLUSION: The Girdlestone's procedure cannot be a first intention indication, but retains a place in the therapeutic arsenal of certain affections of the hip.

[Occlusion secondary to congenital internal transmesenteric hernia: about 2 cases]. / Occlusion par hernie interne transmesenterique congénitale: à propos de deux cas.

Internal hernia due to mesenteric defect or transmesenteric hernia is a rare cause of acute intestinal obstruction. Its diagnosis is most often done during surgery. The knowledge of its clinical peculiarities allows the preoperative diagnosis. We here report 2 cases of acute intestinal obstruction secondary to congenital transmesenteric hernia in two adult patients. This study aims to highlight the clinical peculiarities of this rare form of internal hernia.