Gestational trophoblastic neoplasia after achieving a nondetectable serum human chorionic gonadotrophin level.

OBJECTIVE: To determine the risk of recurrent trophoblastic disease after normalisation of human chorionic gonadotrophin (hCG) levels in women with hydatidiform mole. DESIGN: A retrospective review of data from a national gestational trophoblastic disease centre. SETTING: The Trophoblastic Disease Unit, Dakar, Senegal. SAMPLE: Women with pregnancies affected by hydatidiform mole registered between 2006 and 2012. METHODS: The women were followed up in accordance with the hospital protocol 'Score de Dakar'. For women who progressed to gestational trophoblastic neoplasia (GTN) the time to onset of GTN, treatment and evolution were evaluated. The rate of evolution to GTN after normalisation of hCG was determined. MAIN OUTCOME MEASURES: Rate of occurrence of GTN after chemotherapy for hydatidiform mole. RESULTS: Five hundred and thirty-one women were diagnosed to have molar pregnancies. According to the hospital's protocol, 107 (20.2%) of these had chemotherapy and 224 (42.2%) had prophylactic chemotherapy. Five hundred and thirteen women (96.4%; 95% confidence interval [95% CI] 95.05-98.14%) achieved remission. Eighteen women (3.4%; 95% CI 1.86-4.94%) developed GTN (11 before remission and seven after remission). Seven women out of the 18 developed GTN after hCG normalisation (1.3%). Five of these seven were diagnosed beyond the recommended period of follow up. The mean interval to diagnosis of GTN was 18.7 months. These seven women underwent combination chemotherapy: five achieved complete remission whereas two died from GTN. CONCLUSIONS: Cytotoxic therapy for hydatidiform mole does not prevent GTN, it delays its diagnosis and promotes GTN after normalisation of hCG.

The impact of Origanum Vulgare essential oil supplementation on sperm motility and subpopulation alterations in bulls, dogs, and rabbits.

Artificial insemination is a widely adopted method in livestock production for various reasons such as health security and genetic improvement. Although sperm motility is of paramount importance in this technique as it directly influences the sperm's ability to fertilize the oocyte. In previous research on human sperm, we observed that in vitro supplementation with Origanum Vulgare essential oil significantly improved sperm motility and antioxidant activities, all without negatively affecting the integrity of their DNA. Based on these promising results, we considered it crucial to explore the potential effects of supplementation with this essential oil on sperm of other species. In this study, we studied the effects of oregano essential oil supplementation on sperm motility of (bulls = 15) (dogs = 15) and (rabbits = 9) and the changes that in vitro incubation with this oil could induce on sub-motile sperm populations of different species. The results of the study showed that in vitro oregano essential oil supplementation had a significant impact on sperm motility in the three species studied. This improvement in sperm motility was accompanied by an increase in the proportion of subpopulations with high velocity and progressivity: an increase of (2.16%, 10% and 4.84%) for subpopulation 1, (6.50%, 5.5% and 3.17%) for subpopulation 4 in bulls, dogs and rabbits respectively. While the subpopulations representing low motile and non-progressive sperm have decreased. These results suggest that the use of oregano essential oil can be a beneficial approach to improve sperm motility in different species, which can have important implications for the success of artificial insemination.

Application of flow injection analysis--photo-induced fluorescence (FIA-PIF) for the determination of α-cypermethrin pesticide residues in natural waters.

Flow injection analysis combined with photo-induced fluorescence (FIA-PIF) has been applied for the determination of α-cypermethrin pesticide residues in Senegalese natural waters, using organic solutions and cyclodextrin (ß-cyclodextrin and 2-hydroxypropyl-ß-cyclodextrin) aqueous media. The α-cypermethrin insecticide has a very weak natural fluorescence, but it is converted into strongly fluorescent photoproduct(s) by UV irradiation. Cyclodextrins were found to enhance the PIF signal. FIA parameters, including mobile phase flow rate, injected volume, and reactor length, were optimized. Analytical performances of the FIA-PIF method for the determination of α-cypermethrin were satisfactory, with concentration linear dynamic ranges over one to two orders of magnitude and with rather low limits of detection and limits of quantification, in the ng mL(-1) range, and relative standard deviations comprised between 1.2% and 3.8%. Application of FIA-PIF for the analysis of fortified natural water samples collected from Senegal yielded good recovery values (84-112%). Because of its high sampling rate, the FIA-PIF method constitutes a rapid analytical tool, useful for quantification of α-cypermethrin residues in natural waters.

[Nocardiosis: 4 cases in Senegal]. / Nocardiose: 4 observations au Sénégal.

The purpose of this report is to describe four cases of nocardiosis observed over an eight-year period in medical units of Principal Hospital in Dakar, Senegal. It is a rare infection occurring mainly in people with weakened immune systems. Pulmonary forms are predominate and clinical and laboratory presentation can mimic pulmonary tuberculosis. Diagnosis should be suspected in patients presenting pulmonary infections and negative sputum bacilloscopy. Nocardia bacteria should be identified before starting antibiotic treatment. Patients require long-term antibiotic treatment with third generation cephalosporins or sulfamethoxazole-trimethoprim.

Insulin therapy in childhood type 1 diabetes: Knowledge and practice in Senegal.

INTRODUCTION: Childhood type 1 diabetes (T1D) is a chronic condition with serious repercussions on both the quality of life of the child and the family. Insulin therapy is the cornerstone of optimal blood sugar control. The main objective of our study was to assess the level of knowledge of physicians about insulin therapy in diabetes. METHODS: This was a multicenter survey over a period of 5 months (from March 5 to August 2, 2018). It took place in five reference university hospital centers in the Dakar region. RESULT: The number of doctors interviewed in our study was 82, 47.6% of whom were confirmed pediatricians or pediatricians in the process of specialization. The number of years of experience in the field of diabetes was on average 3 years. Fast-acting regular insulins were recommended by 75.6% of doctors and mixtures of insulin (intermediate and rapid-acting) by 50% of doctors. Overall, 91% of doctors recommend a variation in insulin injection sites. The "basal bolus" treatment regimen with insulin analogs was recommended by 50% of doctors, while 31.7% recommended it with human insulin. Regarding adapting insulin doses for leisure and sports activities, more than half (54.9%) of the doctors had to reduce the doses. CONCLUSION: This study enabled us to assess the level of knowledge of insulin therapy among doctors caring for children with diabetes in Senegal, which proved to be limited. We recommend the reinforcement and follow-up of training on the management of T1D for providers at the different facilities.

Mapping Artisanal and Small-Scale Gold Mining in Senegal Using Sentinel 2 Data.

Artisanal and small-scale gold mining (ASGM) represents a significant economic activity for communities in developing countries. In southeastern Senegal, this activity has increased in recent years and has become the main source of income for the local population. However, it is also associated with negative environmental, social, and health impacts. Considering the recent development of ASGM in Senegal and the difficulties of the government in monitoring and regulating this activity, this article proposes a method for detecting and mapping ASGM sites in Senegal using Sentinel 2 data and the Google Earth Engine. Two artisanal mining sites in Senegal are selected to test this approach. Detection and mapping are achieved following a processing pipeline. Principal component analysis (PCA) is applied to determine the optimal period of the year for mapping. Separability and threshold (SEaTH) is used to determine the optimal bands or spectral indices to discriminate ASGM from other land use. Finally, automatic classification and mapping of the scenes are achieved with support vector machine (SVM) classifier. The results are then validated based on field observations. The PCA and examination of spectral signatures as a function of time indicate that the best period for discriminate ASGM sites against other types of land use is the end of dry season, when vegetation is minimal. The classification results are presented as a map with different categories of land use. This method could be applied to future Sentinel scenes to monitor the evolution of mining sites and may also be extrapolated to other relevant areas in the Sahel.

Toxicological study of pesticides in air and precipitations of Paris by means of a bioluminescence method.

A detailed toxicological study on several pesticides, including chlorothalonil, cyprodynil, dichlobénil, pendimethaline, trifluraline, and alpha-endosulfan, present at trace levels in air and total atmospheric precipitations of Paris is presented. The pesticides contained in the atmospheric samples, collected during sampling campaigns in February-March 2007, are identified and quantified by a high-performance liquid chromatographic (HPLC)-UV detection method. The toxicity measurements are performed by means of the Microtox bioluminescence method, based on the evaluation of the bioluminescence inhibition of the Vibrio fischeri marine bacteria at two exposure times to the pesticide solutions. The specific toxicity, corresponding to the particular toxicity of the compound under study and represented by the EC(50) parameter, is determined for these pesticides. Also, the global toxicity, which is the toxicity of all micro-pollutants present in the sample under study, is estimated for the extracts of air and atmospheric precipitation (rainwater) samples. The specific toxicities strongly vary with the nature of the pesticide, the EC(50) parameter values being comprised between 0.17 and 0.83 mg/mL and 0.15 and 0.66 mg/mL, respectively, for exposure times of 5 and 15 min. The importance of the atmospheric samples' global toxicity and the respective contribution of the toxic potency of the various pesticides contained in these samples are discussed.

[Tetanus in women of childbearing age at the infectious diseases clinic in Dakar]. / Le tétanos de la femme en age de procréer a la clinique des maladies infectieuses de Dakar.

The objective of this article was to describe the epidemiological and outcome features of tetanus in the woman of childbearing age (WCBAT) and compare them with neonatal tetanus (NT) and other tetanus cases in a hospital department in Dakar from 1998 to 2007. A retrospective study was conducted using the files of WCBAT (15 to 49 years old), NT (3 to 28 days old) and other tetanus cases admitted at the Infectious Diseases Clinic, in Fann University Hospital, from 1998 to 2007. 1484 cases of tetanus were admitted in 10 years, with 176 cases of tetanus of WCBAT (11.8%) and 178 cases of NT (11.9%). In comparison with WCBAT the NT annual hospital rate significantly decreased during the study period whereas other tetanus cases rate remained stable. The average age of WCBAT was 26.1 year old and 57.9% were between 15 and 25 years old. The geographical origin was identical for all patients, with more than 71% coming from suburban areas. Most of the WCBAT cases were housewives (50.9%), single women (75%) without updated tetanus immunization (92%). The main portals of entry of WCBAT were injuries and wounds (67.4%) and maternal tetanus cases were rare (8%), mainly post-abortum. At admission, WCBAT cases were less severe than NT cases but more severe than other tetanus cases. The lethality rate of WCBAT cases (28.4%) was significantly lower than NT cases (50%, p = 0.00003), but higher than the other tetanus cases (22.2%; NS). Prognostic factors were: non-identified or intramuscular injection portal of entry and a Mollaret state III at admission. An intensification of the extended immunization program associated with supplementary immunization campaigns targeting women of child bearing age in high risk districts, are necessary to eradicate neonatal and maternal tetanus in Dakar.

[Pregnancies associated with valvular prosthesis at Dakar Teaching Hospital: prognosis, epidemiological, clinical and therapeutical aspects]. / Prothèse valvulaire cardiaque et grossesse au CHU de Dakar: aspects épidémiologiques, cliniques, pronostiques et modalités thérapeutiques.

OBJECTIVE: The persistence of the rheumatic valvular cardiopathie and the access to cardiac surgery make this association frequent. This work will deal with a description of the epidemiological and clinic profile and the evaluation of the cares to the pregnancies with cardiac valvular prostheses. METHODOLOGY: We took a retrospective study beginning from 1987 to 2006 about 14 cases, which had benefited from collaboration between the Gynaecologic and Obstetric Clinic and the Cardiological Clinic of the University Hospital Center of Dakar. RESULTS: The frequency of pregnancies with valvular prosthesis was of 0.12 per thousand. The average age of our patients was of 27.7 years. The average pregnancy was of 2.3 gestures with extremes of 1st to 12th gestures. The pregnancies were not, in any case, planned. An auricular fibrillation was noticed in four patients. The fraction of ejection of the left ventricle was superior or equal to 60% in 10 cases, the prosthesis was lightly blocked in two cases. Despite the use of anti-vitamin K during the first trimester with 42.86% of the patients, the anticoagulation was effective with the entire cases excepted one who died by lung embolism. The delivery was, in seven cases, realized by caesarean and in two cases by natural way. Two cases of premature and foetal hypotrophy have been noticed. There was no case of malformed children. CONCLUSION: With a multidisciplinary care, the carry of valvular prosthesis can be compatible with pregnancy. The lack of embryopathy and malformed children could incite to propose the oral anticoagulation during the whole sequence of pregnancy.

Development of a new automatic on-site detector of pesticides in natural waters by photo induced fluorescence, application to three phenylurea and benzoylurea herbicide.

Prototypes of on-site automatic photo induced fluorescence detectors of pesticide in natural waters are set up and applied for the determination of the benzoyl- and phenylurea pesticides, namely fluometuron, monolinuron and diflubenzuron. As these pesticides present no native fluorescence the set up system use the photo conversion under UV irradiation of these pesticides into highly fluorescent photoproducts. A first system, called AUTOPIF, (evolution the commercial AQUAPOD system) is develop using a detection via a diode array spectrometer. To improve the sensitivity of the method, a second system, called AUTOPIF+, is developed with a more resolute spectrometer and an intensified CCD camera detection. Analytical applications were carried out in aqueous solution and detected on line with the AUTOPIF and AUTOPIF+ system. The calibration curves are linear over one order of magnitude, and the limits of detection are in the µg mL-1 range. The analytical performances of these methods for the determination of the three pesticides are satisfactory in comparison to other classical PIF methods published for the determination of phenylurea pesticides in aqueous solutions. Our results show that the AUTOPIF and AUTOPIF+ methods are versatile, sensible and can be easily applied as an alert system to detect pollutant residues in naturals waters over a threshold value.

[Neuro-Behçet in a Sub-Saharan Africa Country: a Series of Sixteen Patients in Fann Teaching Hospital, Dakar, Senegal]. / Neuro-Behçet dans un pays d'Afrique subsaharienne : une série de 16 patients au centre hospitalier national universitaire de Fann de Dakar, Sénégal.

Neuro-Behçet (NB) African studies are mainly North African, but Sub-Saharan Africa is not to be outdone. Our aim was to describe diagnostic and therapeutic features of NB in a Senegalese series collected in Dakar. This was a descriptive and retrospective study conducted at the Neurology department of Fann Teaching Hospital in Dakar, Senegal. All patients who met the NB's diagnostic criteria were included. Sixteen patients were collected, 14 males and 2 females with an average age of 40 years [18-71]. The main neurological signs were motor deficit (13 cases), headache (10 cases), and language disorders (4 cases). Extra-neurological signs were dermatological (14 cases), ocular (2 cases), and articular (2 cases) with aseptic unilateral gonarthritis. Fever was present in 9 patients. Neurological involvement was mostly isolated parenchymal (8 cases) or mixed (6 cases). The main clinical forms of NB were rhombencephalitis (8 cases) and retrobulbar optic neuritis (4 cases). Seven patients had a cerebral angio-Behçet with cerebral venous thrombosis (3 cases), ischemic stroke (2 cases), and intracerebral hematoma (2 cases). Under prednisone (16 cases) and azathioprine (3 cases), the short-term clinical outcome was mostly favorable (14 cases) with a modified Rankin scale at 2. NB is an under-diagnosed adult male disease in Sub-Saharan Africa and further studies are needed.

Les études africaines sur le neuro-Behçet (NB) sont majoritairement maghrébines, mais l'Afrique noire n'est pas en reste. L'objectif de l'étude était de décrire les particularités diagnostiques et thérapeutiques du NB dans une série sénégalaise colligée à Dakar. Il s'agit d'une étude rétrospective à visée descriptive menée à la clinique de neurologie du centre hospitalier universitaire de Fann de Dakar, au Sénégal. Tous les patients répondant aux critères diagnostiques de NB ont été inclus. Seize patients ont été colligés, 14 hommes et deux femmes avec un âge moyen de 40 ans [18­71]. Les principaux signes neurologiques étaient un déficit moteur (13 cas), des céphalées (10 cas) et un trouble du langage (4 cas). Les signes extraneurologiques étaient dermatologiques (14 cas), oculaires (2 cas) et articulaires (2 cas) à type de gonarthrite unilatérale aseptique. Une fièvre était présente chez neuf patients. L'atteinte neurologique était majoritairement parenchymateuse isolée (8 cas) ou mixte (6 cas). Les principales formes cliniques de NB étaient la rhombencéphalite (8 cas) et la névrite optique rétrobulbaire (4 cas). Sept patients avaient un angio-Behçet cérébral à type de thromboses veineuses cérébrales (3 cas), d'infarctus cérébraux (2 cas) et d'hématomes intracérébraux (2 cas). Sous prednisone (16 cas) et azathioprine (3 cas), l'évolution clinique à court terme était majoritairement favorable (14 cas) avec un score de Rankin modifié de 2 au moment de l'exeat. Le NB est une maladie de l'homme adulte sous-diagnostiquée en Afrique noire. Des études ultérieures multicentriques nationales et sous-régionales sont souhaitables.

[Radiographic study of the canal anatomy of mandibular premolars in a Senegalese population]. / Etude radiographique de l'anatomie canalaire des premolaires mandibulaires dans une population Senegalaise.

AIM: The purpose of this study was to assess the canal anatomy of mandiblar premolars in Senegalese population. MATERIALS AND METHODS: Retroalveolar radiographs of mandibular premolars of 208 patients in Senegal were obtained. Two experienced practitioners using a long cone tube and the parallel plane technique with angulators took the radiographs. The canal morphology of each tooth was determined in terms of the number of canals radiologically visible to the apex. Any anatomic structure emanating from the pulp chamber or the principal canal to the apex and measuring more than 3 millimetres was considered to be a supplementary canal. RESULTS: For the 208 patients studied, 412 first premolars were present and 4 were absent.Among the 412 teeth, 335 (81.3%) had a single canal, 62 (15.1%) 2 canals, and 17 (3.6%) 3 canals. For the second premolars 408 were present. Of the 408 teeth, 352 (86%) had one canal, 49 (12%) 2 canals, and 8 (2%) 3 canals. CONCLUSION: The prevalence of two or more canals in premolar mandibular from Senegalese patients was similar to that found in the others ethnic population.

[Evaluation of the canal shaping duration with Pro Taper: 50 cases--clinical experience]. / Article original evaluation de la duree de preparation canalaire au Pro Taper: experience clinique a propos de 50 cas.

INTRODUCTION: Shaping canal is one of the most important steps in endodontic treatment. It allows the cleaning solutions to reach the totality of the canal and to control any infection of the canal system. To achieve this goal is not without difficulty with the steel instruments, because of their rigidity. Recently, the Nickel Titanium instruments were introduced in Endodontics, to allow a setting form technically simplified and faster The aim of this study was to evaluate the duration of the canal shaping with the Pro Taper system. MATERIALS AND METHODS: This exploratory study was carried out in Conservative Odontology and Endodontics service (OCE) of the department of Odontology of Faculty of Medicine, Pharmacy and Odonto-Stomatology of the University CheikhAnta Diop of Dakar in 2006. Sixty nine root canals (50 teeth) were shaped with ProTaper. RESULTS: The results showed that an average time of 17.35 minutes was necessary for the shaping of the long canals against 15.38 minutes for the middle canals and 14.29 minutes for the short canals. The average duration of canal shaping of the one-root teeth is 13.76 minutes and 17.77 minutes for the plural root teeth. CONCLUSION: Taking into account the necessity of maintaining the teeth on the arcade during long year; include that we have now to respect imperatively the biological principles during the canal shaping in a restricted duration to realize a dense and hermetic canal obturation of the canal system in the same meeting. The Pro Taper system is so a reliable means.

[Prevalence of cardiovascular risk factors in semi-rural area in Senegal]. / Prévalence des facteurs de risque cardio-vasculaire en milieu semi-rural au Sénégal.

OBJECTIVES: We aim to determine the prevalence of cardiovascular risk factors in the semi-rural population of the community of Gueoul in Senegal. PATIENTS AND METHOD: This is a cross-sectional, observational and descriptive study. We conducted an exhaustive survey in 2012 according to the STEPS wise approach of the world health organization against Senegalese aged of 35 years and over who resided for at least 6 months in semi-rural area in the community of Gueoul. Pregnant women were excluded. Classical cardiovascular risk factors were collected and data analyzed using SPSS 18.0 software. The significance level was agreed for a value of P<0.05. RESULTS: We examined 1411 subjects (1052 women) with a mean age of 48.5±12.68 years. The main cardiovascular risk factors were dyslipidemia (61,1%), physical inactivity (56.2%), abdominal obesity according to the International Diabetes Federation (53.9%), hypertension (46.4%), global obesity (13%), diabetes (7.2%) and smoking (2.5%). Hypertension was significantly associated with diabetes (P=0.001), abdominal obesity (P=0.001) and global obesity (P=0.0001). Sedentarity (P=0.001), global obesity (P=0.0001) and hypertension (P=0.001) were more frequent in women. CONCLUSION: Cardiovascular risk factors are frequent and often associated in semi-rural area of Senegal, particularly in women. This condition should lead to develop prevention strategies of cardiovascular complications.

[Toxic nodular goiter]. / Les goîtres nodulaires toxiques.

INTRODUCTION: To date no study in our country was specifically dedicated on toxic nodular goiter. They were just mentioned in generally studies about hyperthyroidism. METHOD: The authors report a retrospective series of 62 cases of toxic nodular goitre collected between 1979 and 1999 at the internal medical clinic of Dakar teaching hospital. The diagnostic of toxic nodule was retained on following criteria: to existence of one or several thyroid nodule with signs or thyrotoxicosis, the existence of a hyperfixating nodule at 131 iodine scintigraphy. Increasing of T3 and/or T4 thyroide hormone. The aims of the study was to analyse the epidemiological, clinical, and therapeutics aspects. RESULTS: We are collected 49 cases of solitary nodule (79.03%) and 13 cases of multi nodular goitre (20.97%). In the cases of solitary nodule, mean age was 40 years, sex ratio of 0.04 (47 female, 2 men). The nodule was clinically diagnosed in 47 cases (95.9%) and extinctive in 73.5%. 34.3% of patients have cardiothyreosis. In the cases of multi nodular goitre mean age was 45 years, all cases were female, goitre was clinically identified in 95.3% (12 patients) and 46.5% had cardiothyreosis. 62% of patients were lost to follow up during medical treatment. Only 2 patients on the 37 who were addressed for surgery come back after thyroidectomy. CONCLUSION: This study confirm the predominance of toxic nodular goitre in young female, its severity related to cardiothyreosis and underlines the difficulties limited to the therapeutical care.

[Left ventricular hypertrophy in black African subjects with artery hypertension: Results of a cross-sectional survey conducted in semi-rural area in Senegal]. / L'hypertrophie ventriculaire gauche chez le sujet noir Africain hypertendu : résultats d'une enquête transversale, réalisée en milieu semi-rural au Sénégal.

OBJECTIVES: To assess the prevalence of left ventricular hypertrophy according to electrocardiographic and echocardiographic criteria among hypertensive patients living in semi-rural Senegalese area. PATIENTS AND METHODS: According to the World Health Organization STEPSwise approach, we conducted, in November 2012, a cross-sectional and exhaustive study in the population aged at least 35 years old and living for at least six months in the semi-rural area of Guéoul. We researched electrocardiographic and echocardiographic left ventricular hypertrophy in hypertensive subjects. Data were analyzed with SPSS 18.0 software version. The significance level was agreed for a value of P<0.05. RESULTS: We examined 1411 subjects aged on average of 48.5±12.7 years. In total, 654 subjects were hypertensive and screening of left ventricular hypertrophy (LVH) was effective in 515 of them. According to Sokolow-Lyon index, 86 subjects (16.7%) presented electrocardiographic LVH, more frequently in men (P=0.002). According to Cornell index and Cornell product, LVH was founded respectively in 66 (12.8%) and 52 subjects (10.1%), more frequently in female (P=0.0001; P=0.004). It was more common in grade 3 of hypertension however criteria. In echocardiography, prevalence of LVH was 2.2% (13 cases) according to the left ventricular mass, 9.3% (48 cases) according to the left ventricular mass indexed to body surface area and 8.2% (42 cases) according to the left ventricular mass indexed to height2.7. LVH was significantly correlated with the electrocardiographic LVH according to Sokolow-Lyon index (P<0.0001) and the grade 3 of hypertension (P=0.003). CONCLUSION: Although rare in hypertensive Senegalese living in semi-rural area, left ventricular hypertrophy is correlated with severity of grade of hypertension. Screening by electrocardiogram will allow better follow-up of these hypertensive subjects.

Primary Hyperparathyroidism and Pancreatitis: A Rare Association with Multiple Facets.

Primary hyperparathyroidism (PHPT) is rarely associated with the occurrence of acute or chronic pancreatitis. Hypercalcemia plays a major role in the pathogenesis. We report five cases of pancreatitis revealing PHPT. Patients and Methods. This is a retrospective study of 4 years, including all patients admitted to intensive care unit or gastroenterology department, for an acute or chronic pancreatitis revealing primary hyperparathyroidism. Results. We included 5 patients, all female, with mean age 54 years [40-76 years]. The PHPT was in all cases revealed by acute pancreatitis (AP). This one was oedematous in four cases and severe in one case. It occurred twice in calcified chronic pancreatitis (CCP). There was hypercalcemia in all cases. The PHPT was associated with a high rate of parathyroid hormone in 4 cases. The secreting lesion was an adenoma in 5 cases. Two patients had in addition bilateral renal calcifications. The outcome was favorable in 4 patients among whom 3 have had parathyroid surgery. A death was noted by superinfection of necrosis in the case of severe AP. Conclusion. The occurrence of pancreatitis during hyperparathyroidism is rare. Normal or elevated calcemia during acute or chronic pancreatitis should always get attention.

[Prevalence of atherosclerotic carotid plaques in semi-rural Gueoul, Senegal: Survey of 1411 subjects]. / Prévalence des porteurs de plaques d'athérome carotidiennes dans la population semi-rurale de Guéoul au Sénégal : enquête sur 1411 sujets.

AIMS: The purpose of this study was to investigate the prevalence of atherosclerotic carotid plaques and association with cardiovascular risk factors and vascular diseases in a semi-rural area of Gueoul in Senegal. PATIENTS AND METHOD: This was a cross-sectional, descriptive study over a period of one month in 2012 in Senegalese people who were older than 35 years, and resided in semi-rural Gueoul for at least six months. Carotid plaques were measured with a portable Doppler Diadop 50(®) and defined by an intima-media thickness greater than 1.5mm. P-values less than 0.05 were considered statistically significant. RESULTS: The survey involved 1411 individuals with a sex ratio of 2.93 and an average age of 48.5 years. Prevalence of risk factors was high: dyslipidemia (61.1 %), physical inactivity (56.2 %), abdominal obesity (53.9 %), hypertension (46.4 %), obesity (12 %), diabetes (7.2 %) and smoking (2.5 %). Prevalence of atherosclerotic carotid plaques was 6.8 %, including 42.7 % with bilateral plaques. Prevalence increased with age (P=0.001), hypertension (P=0.0001), diabetes (P=0.004) and metabolic syndrome (P=0.008). There were no significant associations with the other risk factors. The presence of carotid plaques was associated with medical history of stroke (P=0.01), myocardial infarction (P=0.02) and peripheral artery obstructive disease (P=0.5). CONCLUSION: Prevalence of atherosclerotic carotid plaques seems weak but it is associated with many cardiovascular risk factors. It requires measures for early diagnosis and prevention of cardiovascular diseases in Senegal.

[Evaluation in vitro of the antibacterial effectiveness of 2.5% sodium hypochlorite on endocanal bacteria related to the time contact within root canal]. / Evaluation in vitro de l'action antibacterienne de l'hypochlorite de sodium a 2.5% en fonction du temps de contact avec les parois canalaires.

INTRODUCTION: The aim of this study was to evaluate the antibacterial effectiveness of 2.5% sodium hypochlorite on endocanal bacteria related to the time contact Within root canal. MATERIALS AND METHODS: 110 teeth were prepared and inoculated with Enterococcus feacalis. All teeth were irrigated with a same volume and exposed a period ranging 1 to 10 min. Canals were sampled before and after time contact. RESULTS: All time reduced the number of bacterial cells within the root canal (p > 0.05). There was no significant difference after the time contact of 3 min (p > 0.05). Lack of effectiveness might be caused by irrigant to reach microorganism in dentinal tubules.

Alternatives approaches to the sub-occipital transtentorial route for pineal tumors: How and when I do it?

Deeply located beneath the corpus callosum and surrounding by crucial veins, the pineal and tectal structures still challenge the surgeon. Either anterior or posterior, many surgical approaches have been developed to reach the pineal region. Most popular are likely the posterior sub-occipital or occipito-parietal transtentorial routes. Others, primarily transcallosal or supracerebellar, may be indicated depending of the extension of the tumors while the transcortical routes (frontal, parietal or atrial) have been almost given up. Our purpose in this article is give a practical overview of how to do and what are the respective indications of all these alternatives approaches developed for pineal tumors.