[Hip paraosteoarthropathy after sciatica nerve injury by quinine intramuscular injection]. / Paraostéoarthropathie de la hanche sur lésion du nerf sciatique par injection intramusculaire de quinine.

INTRODUCTION: Often occurring in central nerve injuries, paraosteoarthropathic conditions are revealed by a stiffness or ankylosis of the joint. Their occurring during peripheral nerve injuries is rare. OBJECTIVE: To report a case of hip paraosteoarthropathy features after sciatica nerve injury by quinine intramuscular injection. MATERIALS AND METHOD: We report a case of a 24-year-old patient presenting with pain, oedema of the left buttock, limitation of bending of the left hip, and antalgic limping associated with a small step because of axonal left sciatic nerve injury. Initial pelvis X-ray and laboratory findings were normal. Reviewed 4 months later with important stiffness of the left hip, a second X-ray showed an atypical paraosteoarthropathy (POA). Chemotherapy and physiotherapy alleviated neurological muscle weakness but did not have any effect on the hip functionality. Surgical excision was the only treatment that improved the amplitude of movements. Evolution 7 years later showed the disappearance of the peripheral nerve-injury signs and the conservation of the movement amplitude obtained after excision, without a return to normal. CONCLUSION-DISCUSSION: Factors pointing to this POA were initial oedema, immobilization because of pain, and trauma by quinine intramuscular injection. The interest is the exceptional occurrence of POA on a peripheral nerve injury (sciatica nerve injury by quinine injection) outside the context of length resuscitation and that sciatica nerve injury is frequent in tropical countries but anachronistic in a developed one.

Psychosocioprofessional and familial becoming of formers Buruli ulcer patients in Benin.

UNLABELLED: Buruli ulcer (BU), an emerging disease caused by Mycobacterium ulcerans, causes severe impairments. In literature, no survey has been devoted to the cured patients returned back home. OBJECTIVE: To analyze the long-term psychosocial, professional and family repercussions of BU on former patients. METHOD: Cross-sectional descriptive and analytic study on 244 formers patients seen at the Screening and Treatment BU Center of Allada from 2005 to 2009 and followed at home from January to July 2010. RESULTS: On the psychosocial level, 50.8% cured patients attributed the disease to witchcraft (mostly adults and teenagers); 90. 2% did not feel guilty (mostly children), 48.9% of the adults felt diminished, 31.7% are depressed and 19.5% anxious. On professional level, 81.0% of workers had gotten back to work, in the same job for 75.0% of them while 25.0% had changed jobs; 90.1% of children went back school, 29.4% followed a normal schooling but 70% did experience academic delay. On family level, 2.5% of patients were rejected by their families. CONCLUSION: After returning home, former UB patients suffered of severe psychosocioprofessional and familial repercussions that suggested an organization of their home monitoring.