[Umbilical Artery Doppler Study Role In The Monitoring And Obstetric Management Of High-Risk Pregnancies]. / Apport De L'Echo-Doppler Dans Le Suivi Des Grossesses A Risque.

OBJECTIVE: to compare aspects of the diastolic component of umbilical artery flow with fetal fate parameters. MATERIAL AND METHODS: this was a prospective, cross-sectional study at the Kaolack Regional Hospital over 6 months including patients with an at-risk pregnancy and a gestational age greater than 20 SA. The aspect of umbilical artery flow, umbilical artery IR and cerebro-placental index were studied.We compared the velocity data with the rates of fetal suffering, low birth weight and perinatal mortality. The statistical analysis was done with EPI info software version 7, Excel 2010 and SPSS 20.0 with a p-value of less than 5%. RESULTS: 46 patients were included with an average age of 24.54 years. The mean gestational age was 33.7 AS. The diastolic component of umbilical artery flow was null in 19.6%; reversed in 10.9%; decreased in 21.7% and normal in 47.8%. Confrontation with fetal fate parameters found a rate of 78.6% fetal suffering in the null or reversed diastolic components group compared to 34.4% in the non-zero diastolic components group. For low birth weight, this rate was 92.9% compared to 28.1%. The perinatal mortality rate was 64.2% compared to 12.5%. CONCLUSION: The umbilical artery Doppler study plays a major role in the monitoring and obstetric management of high-risk pregnancies. Our results demonstrate the correlation between a diastolic component of the flow of the pathological umbilical artery and the adverse outcome of the pregnancy at risk.

OBJECTIF: confronter les aspects de la composante diastolique du flux de l'artère ombilicale aux paramètres du devenir fœtal. MATÉRIEL ET MÉTHODES: il s'agissait d'une étude prospective, transversale à l'Hôpital régional de Kaolack sur 6 moisincluant les patientes avec une grossesse à risque et un âge gestationnel supérieur à 20 SA. Etaient étudiés l'aspect du flux de l'artère ombilicale, l'IR de l'artère ombilicale et l'index cérébro-placentaire. Nous avons confronté les données vélocimétriques au taux de souffrance fœtale, de faible poids de naissance et de mortalité périnatale. L'analyse statistique a été faite avec le logiciel EPI info version 7, Excel 2010 et SPSS 20.0 avec une p-value inférieure à 5%. RÉSULTATS: 46 patientes étaient incluses avec un âge moyen était de 24,54 ans. L'âge gestationnel moyen était de 33,7 SA. La composante diastolique du flux de l'artère ombilicale était nulle dans 19,6% ; inversée dans 10,9% ; diminuée dans 21,7% et normale dans 47,8%.La confrontation avec les paramètres du devenir fœtal trouvait un taux de souffrance fœtale de 78,6% dans le groupe des composantes diastoliques nulles ou inversées contre 34,4% dans le groupe des composantes diastoliques non nulles. Pour le faible poids de naissance ce taux était de 92,9% contre 28,1%. Concernant le taux de mortalité périnatale on notait 64,2% contre 12,5%. CONCLUSION: L'étude Doppler de l'artère ombilicale joue un rôle majeur dans la surveillance et la prise en charge obstétricale des grossesses à risque. Nos résultats démontrent la corrélation entre une composante diastolique du flux de l'artère ombilicale pathologique et l'issue défavorable de la grossesse à risque.

[Performance of magnetic resonance imaging ang genourob laximetry in anterior cruciate ligament rupture in 30 cases]. / Performance de l'imagerie par resonance magnetique et de la laximetrie a genourob dans les ruptures du ligament croise anterieur a propos de 30 cas.

INTRODUCTION: The aim of this work was to evaluate the diagnostic contribution of magnetic resonance imaging and genourob compared to intraoperative arthroscopy. The objective was to implement a protocol based on magnetic resonance imaging and / or genourob. MATERIALS AND METHODS: We did a cross-sectional study from July 18, 2016 to July 19, 2017 at the Maltese hospital comparing the results of MRI and GNRB from 30 patients compared to intraoperative arthroscopy data. RESULTS: Complete break.- In MRI, we obtained a sensitivity (Se) of 95.7%, a specificity (Sp) of 85.7%.- At the GNRB, we found a Se of 87%, a Sp of 42.9%.Partially broken.- In MRI we obtained a Se of 85.7%, a Sp of 95.7%.- At the GNRB, we found a Se of 42.9%, a Sp of 87%. CONCLUSION: MRI is better than GNRB. The GNRB does not improve the results of the MRI. It has no diagnostic contribution in the rupture of the ACL knee. It is a device used by the orthopedists to evaluate knee laxity that does not depend on the ACL alone.

INTRODUCTION: Le but de ce travail était d'évaluer l'apport diagnostique de l'imagerie par résonance magnétique (IRM) et du genourob (GNRB) par rapport à l'arthroscopie per opératoire. L'objectif était de mettre en place un protocole basé sur l'IRM et / ou le GNRB. MATÉRIELS ET MÉTHODES: Nous avons fait une étude transversale allant du 18 Juillet 2016 au 19 juillet 2017au centre hospitalier de l'ordre de malte en comparant les résultats d'IRM et du GNRB de 30 patients par rapport aux données de l'arthroscopie per opératoire. RÉSULTATS: ✓ Rupture complète.- En IRM, nous avons obtenu une sensibilité (Se) de 95,7 %, une spécificité(Sp) de 85,7%.- Au GNRB, nous avons trouvé une Se de 87 %, une Sp de 42,9%.✓ Rupture partielle.- En IRM, nous avons obtenu une Se de 85,7 %, une Spde 95,7%.- Au GNRB, nous avons trouvé uneSe de 42,9 %, une Sp de 87%. CONCLUSION: L'IRM est plus performante que le GNRB. Le GNRB ne permet pas d'améliorer les résultats de l'IRM. Il n'a pas d'apport diagnostique dans la rupture du LCA du genou. C'est un dispositif utilisé par les orthopédistes pour évaluer une laxité du genou qui ne dépend pas du LCA à lui seul.

Diagnosis Dilemma of Angioimmunoblastic T-Cell Lymphoma in Tuberculosis Endemic Region.

Angioimmunoblastic T-cell lymphoma (AITL) is a rare hematologic malignancy recognized in the WHO 2016 classification as a clinical and histological entity. It is a very poorly described disease in Africa due to its rarity and diagnostic difficulties, particularly differential diagnosis with tuberculosis. Here, we report a 57-year-old man who presented with fever, weight loss, and lymphadenopathies. The diagnosis of tuberculosis was carried out based on lymph node fine needle aspiration showing the image of tuberculous adenitis and CT images in favor of necrotic lymphadenopathies. The presence of autoantibodies and the failure of tuberculosis treatment led us to perform a biopsy with immunostaining that confirmed pathological features of AITL. The patient was treated by CHOP-based chemotherapy, and complete remission was achieved. This case highlights the difficulty of recognizing AITL and the importance of considering other potential differential diagnoses of tuberculosis in the endemic region.

[Diagnostic performance of imaging examinations in acute non-traumatic abdominal pain in the radiology department of the Kaolack Regional Hospital]. / Apport de l'imagerie dans la prise en charge des douleurs abdominales aigues non traumatiques au Centre Hospitalier Regional de Kaolack.

AIM: The aim of this work was to evaluate the diagnostic performance of imaging examinations in the presence of acute non-traumatic abdominal pain. MATERIALS AND METHODS: This was a prospective, cross-sectional and descriptive study over 6 months in the radiology and medical imaging department of the Kaolack Regional Hospital, including any patient received for acute non-traumatic abdominal pain with informed consent in whom the etiological diagnosis is supported by an imaging examination. We investigated the etiologies of acute abdominal pain and compared the imaging findings with surgical exploration. Our data were analyzed using SPSS 24.0 and Excel 2013 with a coefficient of significance of less than 5%. RESULTS: 106 patients were enrolled. The mean age was 32 years and the gender-ratio was 1.52 in favour of women. Acute abdominal pain was diffuse in 25.5% of patients and localized in 74.5%, of which 18.9% were at right iliac fossa.Abdominal X-ray was performed alone in 4 patients (3.8%), ultrasound alone in 46 patients (43.3%) and abdominal CT scan in 34 patients (32%). CT was combined with ultrasound in 6 patients (5.7%) and with abdominal X-ray in 16 patients (15%). The initial clinical diagnosis was corrected in 49.1% of patients. The sensitivity of the imaging compared to the final diagnosis retained was 96.2%. CONCLUSION: Imaging represents a turning point in the management of patients with acute non-traumatic abdominal pain by providing better diagnostic guidance and avoiding serious complications and unnecessary interventions.

BUT: le but de ce travail était d'évaluer les performances diagnostiques des examens d'imagerie devant des douleurs abdominales aigües non traumatiques. MATÉRIELS ET MÉTHODES: il s'agissait d'une étude prospective, transversale et descriptive sur 06 mois dans le service de radiologie et imagerie médicale de l'hôpital régional de Kaolack, incluant tout patient reçu pour douleur abdominale aigue non traumatique avec son consentement éclairé chez qui le diagnostic étiologique est appuyé par un examen d'imagerie. Nous avons recherché les étiologies des douleurs abdominales aigues et confronter les résultats de l'imagerie à l'exploration chirurgicale. Nos données ont été analysés avec les logiciels SPSS 24.0 et Excel 2013 avec un coefficient de significativité inférieur à 5%. RÉSULTATS: 106 patients ont été retenu. L'âge moyen était de 32 ans et le genre-ratio de 1,52 en faveur des femmes. La douleur abdominale aigüe était diffuse chez 25,5% des patients et localisée chez 74,5% dont 18,9% à la FID. L'ASP a été réalisé seul chez 4 patients (3,8%), l'échographie seule chez 46 patients (43,3%) et le scanner abdominal chez 34 patients (32%). Le scanner a été couplé à l'échographie chez 6 patients (5,7%) et avec l'ASP chez 16 patients (15%). Le diagnostic clinique initial a été rectifié chez 49,1% des patients. La sensibilité de l'imagerie par rapport au diagnostic final retenu était de 96,2%. CONCLUSION: L'imagerie constitue un tournant décisif dans la prise en charge des patients présentant une douleur abdominale aigüe non traumatique en apportant une meilleure orientation diagnostique évitant aux patients des complications graves et des interventions inutiles.

Varibaculum timonense sp. nov., a new bacterial species isolated from human stool sample.

Varibaculum timonense sp. nov. strain Marseille-P3369T (= CSURP3369) is a new species from the order Actinomycetales that has been isolated from a fresh stool sample of a healthy French woman.

Corynebacterium urinapleomorphum sp. nov., a new bacterial species isolated from human urine sample.

Corynebacterium urinapleomorphum sp. nov. stain Marseille-P2799T (= CSURP2799; = DSM103272) is a new species from the order Corynebacteriales that was isolated from urine of a 2-month-old child with gastroenteritis.

Corynebacterium bouchesdurhonense sp. nov., and Corynebacterium provencense sp. nov., two new species isolated from obese patients.

Corynebacterium bouchesdurhonense sp. nov. strain Marseille-P2067T (= CSURP2067; = DSM100846) and Corynebacterium provencense sp. nov. strain Marseille-P2161T (= CSURP2161; = DSM101074) are two new species from the order Corynebacteriales that were isolated from obese French individuals.

Varibaculum massiliense sp. nov., a new bacterium isolated from human urine with culturomics.

Varibaculum massiliense sp. nov. strain Marseille-P2802T (= CSUR P2802 = DSM 103074) is a new species within the genus Varibaculum in the phylum Actinobacteria that was isolated from the urine of a 59-year-old man treated with chronic haemodialysis for diabetic nephropathy.

[Evaluation of Physical Integrity and Biological Efficacy of Two Types of LLINs Aged 5 to 36 Months Sampled in 11 Districts of Senegal]. / Évaluation de l'état physique et de l'efficacité biologique de deux types de moustiquaires imprégnées à longue durée d'action utilisés depuis 5 à 36 mois et collectés dans 11 districts du Sénégal.

The long-lasting insecticidal nets (LLINs) have been promulgated to compensate the low re-impregnation rate of conventional mosquito nets. Today, the cornerstone of the fight against malaria vectors is based on a large distribution of these LLINs for universal coverage. Despite this promotion, the question of their effective life in operational conditions remains unresolved. Between September and October 2013, a survey was conducted in 11 districts of Senegal where LLINs were sampled and routed to the laboratory for assessing their physical integrity and biological effectiveness. A total of 207 LLINs that were sampled in the 11 districts have been monitored during this study. Our results showed that Olyset® Net and PermaNet® 2.0 are the most represented brands in the districts. These two major brands have a good biological efficiency providing a high rate of knockdown despite their failing physical integrity.

Les moustiquaires imprégnées à longue durée d'action (MILDA) ont été promues pour pallier le faible taux de réimprégnation des moustiquaires conventionnelles. Aujourd'hui, la pierre angulaire de la lutte antivectorielle repose sur une forte distribution de ces MILDA pour une couverture universelle. En dépit de cette promotion, la question de leur durée de vie effective en conditions opérationnelles reste toujours posée. Entre septembre et octobre 2013, une enquête a été menée dans 11 districts du Sénégal. Des MILDA y ont été échantillonnées et acheminées au laboratoire pour évaluer leur intégrité physique et leur efficacité biologique. Au total, 207 MILDA ont été collectées dans les 11 districts suivis au cours de cette étude. Nos résultats ont montré que les deux marques majoritairement distribuées présentaient une bonne efficacité biologique, car induisant un taux élevé de knock-down malgré leur état détérioré.

[Syndrome of "Coup de fouet". A case description and literature review]. / Syndrome du "Coup de Fouet" syndrome d'un cas et revue de la litterature.

The authors bring back the observation of a 48-year-old woman having induced a big painful left calf. The dread os a thrombophlebitis drew away the strarting of an anticoagulative treatment. This treatment was later supended in front of the putting in an a bvious place in echo-Doppler of a haematoma of the calf linked to a normal side of venous fluxes. This table made recall a syndrome of "coup de fouet". It is about a desease characterised by the unpromted rupture of a deep vein of the calf accomplishing a haematoma. It happens in repose or in step as at our patient. It posed a problem of differential diagnosis with a thrombophlebitis of lower limb. Evolution was favourable under treatment linking pause, an anti inflammatory and the haematoma paracentesis under echographique guidance .

[Congenital choledocal cyst of adult: report of two cases]. / Kyste congenital du choledoque de l'adulte : a propos de deux observations.

INTRODUCTION: Congenital choledochal cyst is a congenital dilatation of the biliary tract often associated with a long common bilio-pancreatic duct without obstruction. PATIENTS AND METHOD: We report the case of two women who presented a congenital choledochal cyst. RESULTS: For the first patient, the diagnosis was effected during a laparoscopic cholecystectomy for a gall bladder lithiasis. The second one presented repeted access of angiocholitis. Echography and abdominal tomodensitometry found the congenital choledochal cyst. Percutaneous opacification of the cyst found a long common biliopancreatic duct in the second patient. A complete resection of the cyst with a cholangiojejunal anastomosis was performed for both patients. The treatment was successfull for the first one and the second one was deceased three days after the operation. CONCLUSION: This case report underlines the clinical polymorphysm, the morphologic anomaly and the treatment of congenital choledochal cyst which require total resection.

[Cerebral metastasis for the identification of carcinomas of the lung: the use of mulimodality medical images. A case repport]. / Metastase cerebrale revelatrice d'un carinome epidermoide pulmonaire: apport de l'imagerie multinodalite.

INTRODUCTION: Diagnosis of carcinomas of unknown primary site has proved to be difficult for many reasons. PATIENT AND METHODS: In this study, case in which cerebral metastasis is confirmed by biopsy technique with no identified primary site at the onset of treatment is presented here in. RESULTS: The multimolity medical images was used to detect pulmonary hearths compatibles with a malignant histology. Further analysis diagnosed a primitive neoplasm. CONCLUSION: This study illustrates the interest of this technology in medical imagery in the early detection of primitive cancers on which the forecast depends.

[Selective salpingography in the treatment of infertility caused by proximal tubal obstruction: apropos of 122 cases treated in Dakar]. / La salpingographie sélective dans le traitement des infertilités par obstacle tubaire proximal: à propos de 122 cas traités à Dakar.

One hundred and twenty-two women who had not conceived after more than one year of unprotected sexual relations underwent selective salpingography. All had been shown to have proximal obstruction of the fallopian tube by standard hysterosalpingography. The women underwent the procedure as outpatients during the follicular period. They were given prophylactic antibiotic treatment and salpingography was performed by a radiologist in an X-ray room. We used the commercial sets of Cook and Zorn. The mean age of patients was 34 years (range 28 to 46) and the mean duration of infertility was 7.7 years (range 2.2 to 14 years). Two hundred and forty tubes were examined, of which 213 were cleared of obstruction (88.7%), with both tubes affected in 66% of cases and only one tube affected in 33% of cases. All patients had at least one patent tube after the procedure. The patent tube was normal in 73% of cases (177 tubes) and abnormal in 15% (36 tubes). Catheterization failed in 11.3% of cases (27 tubes). Forty-nine women conceived spontaneously during the 2- to 12-month follow-up period, and 39 of these women delivered healthy babies. No extrauterine pregnancies or serious complications were reported. The most frequent side effects were slight pain, bleeding and nausea. One perforated tube was reported and none of the patients died. The greatest difficulties encountered were a lack of cooperation in patients with previous painful experiences of hysterogram and catheterization problems in women with a strongly flexed or distorted uterus. Complications were minimal and the one case of tubal perforation at the beginning of the series had no serious consequences. Thus, selective salpingography should be used more widely because it is simple and more cost-effective than the surgical management of tubal obstruction and artificial insemination. Our results suggest that this procedure should be the first-line treatment of infertility caused by proximally obstructed fallopian tubes.

[Contribution of mammography and echography to the diagnosis of breast cancer in Dakar: apropos of 25 cases]. / Apport de la mammographie et de l'échographie dans le diagnostic du cancer du sein à Dakar: à propos de 25 cas.

The authors studied mammographic features of 25 patients with malignant breast disease. 24 of them had ultrasonographic (US) exploration. The study appreciates epidemiological, mammographic and US aspects; It also appreciates the correlation between images and histology. The mean age is 40. Six women (26%) had family history cancer. The mean reason of the exploration is a mass in 76%. At mammography, contours of cancerous opacities are irregular in 56%, regular in 16%. In 20%, the cancer showed no opacity. At US, we find a lack that appears irregular in 48%, regular in 24%, without traduction in 4%, non precised in 24%. Mammography sensitivity was 80%, false negative rate 28% and false positive rate 8% against respectively 96%, 32% et 12% for echography. This study shows that US is more sensitive but less specific than mammography. However, we recommend the use of mammography and echography together because in Senegal, cancer happens at an earlier age at with breast is easier to analyze at US.

[Multifocal tuberculosis with epididymitis and orchitis in an HIV negative patient]. / Tuberculose multifocale avec atteinte orchi-épididymaire chez un patient non infecté par le VIH.

This case report try to point out the importance of early diagnosis, and an appropriate treatment in multifocal tuberculosis including a testicular localization. A 25 year-old male with a past history of tuberculosis contact and untreated chronic cough with haemoptysis is admitted in our in-patient clinic. Eighteen months earlier, he presented a long course fever, with lumbar pain. Thereafter, the patient condition worsened as he lost weight and developed an enlargement of the right testicle with an scrotal abscess fistulous and a meningo-encephalitis clinical presentation. The bacilloscopy performed on gastric specimen and scrotal caseous was negative. The cerebrospinal fluid was clear and showed a mixed formula with 370 cells including 50% of lymphocytes, an elevated albumin (0.70g/l) and low glucose (0.10g/l) . Sterile pus was detected in urine. The tuberculosis skin test was positive. In addition to the clinical and epidemiological context, the radiological findings (chest and spine X-ray, testicular ultrasonography, cerebral CT Scan) were consistent with multifocal tuberculosis infection with lung miliary, epididymal-orchitis, and brain tuberculomas. The patient was treated successfully using a two-step protocol: two-month treatment with isoniazid, rifampicin, ethambutol and pyrazinamid altogether; followed by a seven-month regimen with isoniazid and rifampicin. Nevertheless,the patient is likely to develop static trouble and infertility because of the spine sequela and testicle atrophy he presented.

[Pulmonary tuberculosis in adults: radiological aspects before starting treatment]. / Tuberculose pulmonaire chez l'adulte: aspects radiologiques avant l'institution du traitement.

We studied chest radiological images in 69 patients with tuberculosis, 4 of them were affected by HIV-infection. The sex ratio was 2.63. We observed 177 abnormal pulmonary images associated in different ways. Bilateral and diffuse radiological signs were noted. Tubercular cavern was the most frequent image (92.90%). It corresponded to a clear circular and oval image surrounded with a regular wall. It can locate in lesional source or healthy parenchyme. Caverns size was situated between 10 to 80 mm. The reticular and nodular infiltration (69%) as indicated associated linear and micro-nodular images. Lobar pneumoniae (44.90%) and segmental pneumoniae (4.30%) corresponded to alveolar lesions showing an opaque and homogeneous tonality image limited by seizures. They were retractile (P = 0.015). Principal mediastinal signs were relative to the presence of adenopathies (11.6%) associated with pleuropulmonary images. Four patients (5.79%) presented tuberculosis association with positive HIV serology. These patients did not present any radiological particularity. They did not show mediastinal adenopathies aspects. Pleural images better corresponded to a localize pachypleurite (13 cas) than a liquid extravasation (8 cases).

[Diagnostic x-ray computed tomography pf craniocerebral tumors. Apropos of 108 cases collected at the Soweto Center of Dakar]. / Diagnostic tomodensitométrique des tumeurs crânio-encéphaliques. A propos de 108 cas colligés au Centre Soweto de Dakar.

The authors report a retrospective study over two years in order to assess computed tomography (CT) in the diagnosis of intracranial tumors. Results were analysed on the epidemiological, clinical and CT point of view. CT is a sensitive and non invasive exploration which should be performed first when intracranial tumor is suspected. However its cost remain high for most of the patient.

[Aetiological aspects of neurological diseases in Dakar: follow-up after 10 years (1986-1995)]. / Aspects etiologiques des affections neurologiques à Dakar: bilan de 10 années (1986-1995).

Because of the apparition of new risk factors and numerous progresses in investigation methods, authors take stock of neurological diseases of patients admitted in Clinique Neurologique of Fann during the last ten years. The 8539 cases repartition is as followed: 4736 males and 3803 female. Their ages ranged between 3 and 80 years with 2130 deaths corresponding to 24.94%. Annual mean of admission is 853 +/- 42 cases. Aetiological data are: stroke (3910 cases 45.78% with 60.56% of death). The following is peripheral neuropathieswith 714 cases(8.61%) and the spinal cord compression with 692 cases (8.10%). Comparision of frequencies of different aetiologies with those of previous studies shows that the small capacity of the neurological department is a restricting factor for the entry frequencies of neurological patients; the principal pathologies got small variations from one decade to another. In the opposite, some aetiologies have disappeared (neurological syphilitis, trypanosomiasis, neurocyticercosis, cerebral mycosis). Some eatiologies remain unprecised (infectious diseases, peripheral neuropathies, degenerative diseases).

[Growing skull fracture with cerebral and ventricular hernia after brain trauma]. / Fracture evolutive avec hernie cérébrale et ventriculaire post-traumatique.

Authors report the case of 3 years old boy. He represented a severe head injury with dura mater damage and skull fracture. He has been operated and few years later, he present a vault tumefaction. CT scan show a very large bone defect, a cerebral and ventricular hernia. Mecanism and causal factors are discussed.

[Arachnoid cyst with orbital meningocele: a case report]. / Kyste arachnoidien avec meningocele orbitaire: à propos d'un cas.

Arachnoïd cysts are rare. 1% of cranial neoformation. We report the case of a six years old boy who presented an arachnoid cyst impressive by its compressive phenomena. Present complaint are macrocrania and right orbitary tumor. Tomodensitometry reveal a huge liquid collection which starts from the right cerebellopontine angle to the frontal region and invading the orbital cavity. In addition we have a thalamic fusion Its congenital origin is obvious. The associated malformations seem to be related to an anomaly of the centre line. This case point out the primum movens of malformations which are often complex and whose antenatal diagnosis is rare in our countries