[Unilateral isolated partial third nerve palsy and sphenoiditis in a child: A case report]. / Paralysie partielle du III isolée d'origine sinusienne chez un enfant : à propos d'un cas.

We report a case of unilateral mydriasis associated with sphenoid sinusitis and mucocele in a child. An 11-year-old girl with a history of unilateral mydriasis was referred for ophthalmologic examination. She complained of a mild headache over the past four days. The right pupil was dilated and nonreactive to light. The left pupil was normal and reactive. There was no ptosis or other focal neurological deficit. She was orthotropic. Visual acuity in both eyes, ocular motility and fundi were normal. Magnetic resonance imaging (MRI) showed a sphenoid sinus mucocele with sphenoiditis. The diagnosis was partial third nerve palsy without ophthalmoplegia. Treatment with antibiotics was initiated and led to complete resolution of the mydriasis. Sphenoid sinus mucoceles are relatively rare. Failure to diagnose and treat can lead to serious neurologic sequellae such as third nerve palsy, compressive optic neuropathy, cavernous sinus thrombosis, meningitis or brain abscess. Head imaging by reconstructed CT and MRI can lead to the diagnosis of mucocele. Isolated unilateral mydriasis as a sign of third nerve palsy may be caused by a slowly enlarging lesion. In a child with isolated unilateral mydriasis, head MRI should be performed to rule out a compressive lesion of the oculomotor nerve.

Pathologies ORL revelees par des complications ophtalmologiques : a propos de trois cas

Nous rapportons trois cas cliniques qui demontraient chacun une pathologie d'origine oto-rhino-laryngee (ORL) initiale; qui etait revelee par une atteinte oculo-orbitaire. Ces trois cas etaient differents de part leurs etiologies. Leur symptomatologie commune associait la baisse d'acuite visuelle et l'exophtalmie. Un examen ORL complet est indispensable devant toutes atteintes oculo-orbitaires pour la recherche d'un eventuel foyer primitif

[Trichobezoars, a little known clinical entity]. / Le trichobézoard, une entité clinique peu courante.

A voluminous trichobezoar was discovered in an 11-year-old girl without major clinical implications. The diagnosis was made by endoscopy and surgery was performed without complications.

Les cas d'avortements a la Maternite de Befelatanana au cours de l'annee 1997

Cette étude rétrospective, menée en 1997, a pour but d'évaluer la fréquence des avortements spontanés et provoqués admis à la Maternité de Befelatanana, d'en identifier les causes et les facteurs de risques, et d'envisager une politique visant à réduire leur survenue. 958 avortements ont été recensés. L' âge moyen des patientes a été de 28 ans. Les avortements compliqués représentent 30,3% des cas (289 cas). 1 femme sur 25 ayant avorté est décédée. L'étude a permis de préciser certaines causes de la pratique d'avortement : état de santé de la mère, facteurs socio-économiques et culturels. L'avortement constitue un échec de la Santé de la Reproduction. Le contrôle des avortements passe par une éducation sanitaire où la planification familiale a un rôle important, par la prise en charge correcte des avortements et de leurs complications. Mais avant tout, les conditions de vie sont à améliorer

[Street-vendor foods: quality of ice creams, sherbets and sorbets sold in the urban agglomeration of Antananarivo]. / Aliments de rue: qualité des glaces, crèmes glacées et sorbets commercialisés dans l'agglomération urbaine d'Antananarivo.

A survey of selling conditions and bacteriological examinations of ice-cream was carried-out in Antananarivo from June 1996 to May 1997. The way of investigation by vendors and of bacteriological examinations were widely described. Sellers had classic features of a street-vended food vendor: uneducated, no having professional training and mishandling foodstuffs. 202 samples of ice-cream were collected. The contamination prevalence rate was of 95% +/- 3.7%. Salmonella typhimurium was isolated from one sample. Immediate and rigourous measures ought to be put into effect by authorities to right this alarming situation.