Rhinologic signs associated with snuff taking.

OBJECTIVE: To study rhinologic signs associated with nasal tobacco (snuff) intake in Parakou, northern Benin. MATERIALS AND METHODS: A cross-sectional descriptive comparative study included 300 tobacco snuff takers and 300 subjects who did not use tobacco at all. The sampling technique was a stratified 4-stage random sample for non-users and a convenience non-random sample for snuff takers. RESULTS: The sex-ratio was 0.92 in non-users and 41.9 in snuff takers. Duration of snuff taking was more than 20 years in 24.3% of cases. The symptoms studied were significantly more frequent in snuff takers than non-users (P<0.05). Snoring was reported by 58.3% of snuff takers, versus 5.7% of non-users (P=0.000). Nasal obstruction and rhinorrhea were reported by respectively 26.3% and 22.7% of snuff takers, versus 6.3% and 5.3% of non-users (P=0.000). Hyposmia was reported by 14% of snuff takers, versus 1.3% of non-users (P=0.000). Anterior rhinoscopy found abnormalities in 81.7% of snuff takers, compared to 10.67% of non-users. Nasal hypertrichosis was more frequent in snuff takers than non-users: 40% versus 5% (P=0.000). CONCLUSION: Nasal intake of tobacco is responsible for morbidity in snuff takers compared to non-users of tobacco.

[Prevalence and control of asthma among medical students at Parakou, Benin]. / Prévalence et contrôle de l'asthme chez les étudiants en médecine à Parakou, Bénin.

INTRODUCTION: The objective of this study was to determine the prevalence and to assess the control of asthma among students at the faculty of medicine of the university of Parakou in Benin. METHODS: This cross-sectional study was carried out between January and November 2017. The Asthma Screening Questionnaire (ASQ) was filled out by medical students, followed by the Asthma Control Test questionnaire for those who were suspected of having clinical asthma (ASQ≥4). All students with clinical asthma or with a history of asthma were invited to perform a spirometry test. RESULTS: Overall, 837 (73.7%) students out of 1136 were included. The prevalence was 9.1% for ever diagnosed asthma, 14% for clinical asthma and 5.3% for confirmed asthma. Among 761 students, without a previous asthma diagnosis, 10.4% had clinical asthma and 3.3% a confirmed asthma. Female sex (aOR=2.1; 95%CI =1.0-4.1), a previous diagnosis of asthma (aOR=7; 95% CI=3.2-15.2) and allergic rhinitis (aOR=3.9; 95% CI=1.9-7.8) were associated with confirmed asthma. Asthma symptoms were controlled in 92 (78.6%) students, partly controlled in 20 (17.1%), and not controlled in 5 (4.3%). CONCLUSION: Clinical manifestations of asthma are frequent among medical students at Parakou. Some are not well controlled, suggesting a need for greater awareness and an improvement in clinical follow-up.

Symptoms of allergic rhinitis in Parakou, Benin: Prevalence, severity and associated factors.

AIMS: Allergic rhinitis (AR) is an extremely common disease. This study aimed to determine the prevalence and severity of AR symptoms and potential associated factors, in Parakou, a city in Benin. MATERIALS AND METHODS: A cross-sectional study was conducted between April and July 2016, involving inhabitants of the city aged between 6 and 65 years. Cluster sampling was carried out. AR symptoms were defined as the simultaneous presence of rhinorrhea, nasal obstruction and sneezing without evidence of respiratory infection. Data were analyzed on EpiData Analysis v2.2.2.183 and then on R.3.2.1. RESULTS: Three hundred and ninety-five inhabitants were questioned, with a male/female ratio of 1.32, and median age of 19 years. One hundred and forty-one (35.7%) had AR symptoms, 47 (33.3%) had family history of atopy, and 87 (61.7%) had allergic conjunctivitis. The main triggers were house dust (139; 98.5%) and air pollution (111; 78.7%). On multivariate analysis, associated factors were age<18 years (P<0.05), exposure to house dust (P<0.001), and personal history of urticaria (P<0.001) or allergic conjunctivitis (P<0.01). Twenty-eight subjects (19.9%) had persistent symptoms. Forty-three (30.5%) had moderate/severe symptoms, associated with age≥18 years (P<0.01), family history of atopy (P<0.01), personal history of atopic eczema/dermatitis (P<0.01), and presence of a dog or cat at home (P=0.01). CONCLUSION: The prevalence of AR symptoms in Parakou was high. A non-negligible proportion of symptoms were severe. This disease merits special attention in the city.

[Cervicofacial cellulitis of dental origin: etiology, epidemiological and therapeutic aspects]. / Aspects étio-épidémiologiques et thérapeutiques des cellulites cervico-faciales d'origine dentaire.

OBJECTIVES: Cervicofacial cellulitises are dominated by dental affections. The aim of this study is to describe etio-epidemiological and therapeutic aspects of cervicofacial cellulitis of dental cause at the CNHU-HKM in Cotonou (Benin). METHODS: It's a retrospective study from 1998 to 2007 included patients with inflammatory cervicofacial tumefaction of dental cause. A glycaemia, a HIV serology and a blood formula numeration are realized. Some patients practiced standard oral and dental radio. Patients were hospitalized and received mono, bi or triple antibiotic. Lancing with swab of pus for cytobacteriological and antibiogram examination was realized for some of patients. Dental cares were been systematic. RESULTS: 68 cases whose 53 dental cause where been collected 77.94%. Bracket concern patients between 0-20 and 20-40 years old (64.15%). Males were, more concerned. Dental traumatisms find again (18.88%), tooth decay (56.60%) and 24.53% patients practiced dental extraction. Anti inflammatory practiced by 67.92% patients associated to antibiotic in 41.51% cases. The three latest molar were concerned to 26 patients. Among those last 22 had attack of mandibular teeth. Treatment consisted in lancing drainage to 2/3 patients in 83.40% cases associated to tri antibiotic. Evolution has been favourable with recovery to 86.67%; 6 decreases to 13.33% cases. CONCLUSIONS: Cervicofacial cellulitises are dangerous, rapidly responsible of deceases by extension. A better oral and dental hygiene would improved prognosis.

[Seven cases of inverted nasosinusal papilloma treated at Cotonou]. / Sept cas de papillome inversé nasosinusien pris en charge à Cotonou.

OBJECTIVE: Sinonasal inverted papilloma is a rare benign tumor with a high recurrence rate and potential malignant transformation. The purpose of this study was to analyze the clinical and radiological aspects and to identify the suitable surgical approaches to be used in developing countries. METHODOLOGY: In 3 years, 7 cases have been analyzed in a retrospective study. Patients presented with unilateral nasal obstruction and epitasis, a whitish unilateral polypoid mass, sinonasal opacity with osteolysis on CT scan or on sinus X-ray. Using these data we adopted the Krouse staging which classifies the disease in four stages and accordingly the appropriate surgical approach was used. The diagnosis was confirmed by histological examination of the biopsied specimen. RESULTS: Average age 48.28 years, predominant sex male. Symptom: unilateral nasal obstruction 5, bilateral nasal obstruction 1, epistaxis 5. The average time-delay before consultation was 73 months. The combined endonasal endoscopic and vestibular was the most commonly used approach (4 cases). The results were satisfying. After a minimal follow up of 2 years, one case of recurrence was detected after 4 years. CONCLUSION: CT scan is an essential tool for the diagnosis and detecting the extension of sinonasal inverted papillomas. Better results were obtained with a surgical approach that combined a vestibular approach and an endonasal endoscopic approach in our region.

[Modification of expiratory peak flow (EPF) in 14 asthmatic subjects from Benin by short duration exercise training]. / Modification du debit expiratoire de pointe par un entrainement de courte duree: cas de 14 sujets asyhmatiques Beninois.

INTRODUCTION: Asthma is a world wide public health problem. It is the most commom chronic disease of school age children. Its severity is in constant increase. The frequency of the hospitalizations for asthma increased in practically all countries. Physical exercises and sport are used more and more as therapeutic means, in northern deveopped countries of where it was very early understood that it is necessary to integrate the asthmatic subjects into a program of specific physical training. This study undertaken in south saharian african country considers also assiduity in a physical training program as the factor of increase in the expiratory peak flow, of reinforcement of some principal muscles necessary to the improvement, and of the respiratory function of the asthmatic subject. Physical exercise is used as a non pharmacological therapy of asthma. PATIENTS AND METHODS: This transversal study was carried out on fourteen asthmatic subjects of colleges in Porto-Novo's town, aged 15 years old to 25 years, of the two sexes. RESULTS: The results showed that: the Expiratory Peak Flow of Point (EPF) of the subjects at the beginning of the program is lower than the minimal average value of the group whatever the sex; the subjects average EPF increased from approximately 35% compared to the average at the beginning of the program; the subjects from family with asthmatic line, are much more inclined with respiratory embarrassments post-exercises than those who did not come from it; the respiratory embarrassments post-exercises noticed in the first weeks, grew blurred before the end of the program. This study suggests physical exercise adapted to the asthmatic subjects for the improvement of their health.

Differences in cytokine responses to Onchocerca volvulus extract and recombinant Ov33 and OvL3-1 proteins in exposed subjects with various parasitologic and clinical states.

Subjects with generalized onchocerciasis (GEN), with the sowdah form, and with exposure but without onchocerciasis (endemic normal/putatively immune; EN/PI) were studied for cytokine responses to Onchocerca volvulus extract (OvAg) and recombinant Ov33 and OvL3-1 proteins. Higher levels of cytokines were produced in response to OvAgs in sowdah and EN/PI than in GEN subjects. Peripheral blood mononuclear cells did not produce interferon-gamma in response to antigens. OvAg induced interleukin (IL)-5, IL-2, granulocyte-macrophage colony-stimulating factor (GM-CSF), and soluble IL-2 receptor. EN/PI and sowdah persons produced significantly more IL-5 and IL-2 than GEN subjects, and EN/PI subjects had significantly higher GM-CSF levels than GEN persons. The low IL-5 and GM-CSF levels in GEN subjects were increased by addition of exogenous IL-2. Ov33 and OvL3-1 stimulated production of IL-10 and less IL-5 and IL-2. The study groups did not show a strict Th2-like cytokine response.

Characterization of human immune responses to the cytosolic superoxide dismutase and glutathione S-transferase from Onchocerca volvulus.

In onchocerciasis patients and in O. volvulus-exposed individuals without signs of onchocericiasis, T- and B-cell responses to two recombinantly expressed O. volvulus enzymes were analysed and compared to responses to total protein extract of adult parasites. The cytosolic enzymes Cu/Zn superoxide dismutase 1 (OvSOD1) and glutathione S-transferase 2 (OvGST2) represent 2 detoxifying molecules which may play an important role in parasite defense against host-induced oxidative stress. The T-cell response to the two recombinant proteins was analysed by investigating the cytokine responses of peripheral blood mononuclear cells. Induction of IL-5 at the mRNA level and IL-5 and IL-10 at the protein level was demonstrated in patients with the generalized form of onchocerciasis and endemic normals without clinical manifestations. IFN-gamma was not found to be induced by either antigen. This pattern of lymphokine expression is indicative of a Th2-type response. Compared to patients with the generalized form, a higher level of cytokine induction was observed in the group of endemic normals. Low but significant IgG levels were observed against OvSOD1 in patients with onchocerciasis; higher antibody levels were found against OvGST2 in patients and endemic normals. The highest IgG levels were detected against the crude O. volvulus extract. These results indicate that the two recombinant O. volvulus proteins induce moderate T and B cell responses.