Prenatal Exophthalmia Revealing a Postnatal Orbital Teratoma.

PURPOSE: Teratomas are congenital tumors of stem cells derived from the three germ layers. They are frequently located in the sacrococcygeal region. Orbital teratoma is rare with less than 70 cases reported until 2016. We report the case of prenatal exophthalmia discovered by ultrasound exam which turned out to be a teratoma postnatally. The newborn in our case was female, just as described in the literature. Treatment consisted of total removal of the teratoma and the eyeball. Reconstructive surgery remains a big challenge since our medical technology is limited. CONCLUSION: A prenatal exophthalmia on fetal ultrasound should make us think of a teratoma, even if it is very rare. Fetal orbital teratoma may be associated with fetal survival. The infant will benefit from a reconstructive surgery of the orbit.

[Prevalence and factors associated with malnutrition in infants aged 6 to 23 months admitted to paediatric emergencies department at the Yalgado Ouédraogo University Hospital in Burkina Faso]. / Prevalence et facteurs associes a la malnutrition des nourrissons ages de 6 a 23 mois admis aux urgences pediatriques du Centre Hospitalier Universitaire Yalgado Ouedraogo, Burkina Faso.

INTRODUCTION: Despite the implementation of various nutritional interventions, access to healthy food in sufficient quantity for the population remain challenging in Burkina Faso. The objective of this study was to assess the nutritional status of infants aged 6-23 months and to identify factors associated with malnutrition. PATIENTS AND METHODS: From 1st May to 31th July 2016, we conducted a cross-sectional study at Yalgado Ouedraogo University Hospital paediatric department. Infants aged 6 to 23 months admitted to the paediatric emergency department were enrolled. Factors associated with malnutrition were identified using multivariate logistic regression. RESULTS: A total of 295 infants were included, at an average age of 13 months (standard deviation: 5.1 months). The prevalence of wasting was 15%, 13% was stuntingand 7% was underweight. The majority of mothers (69%) were unaware of exclusive breastfeeding and only 22% knew the importance of colostrum. In multivariate analysis age ≥ 12 months increased the odds of wasting (adjusted odds ratio [aOR]: 2.3, 95% confidence interval: 1.1-4.7), while knowledge of exclusive breastfeeding reduced the risk of wasting (aOR: 0.4, 95% CI 0.2-0.9). In addition, age ≥12 months (aOR: 0.08, 95% CI: 0.03-0.22), female gender (aOR: 0.31, 95% CI: 0.12-0.77) and absence of dietary restrictions (aOR: 0.13, 95% CI: 0.05-0.3) significantly reduced the odds of stunting. CONCLUSION: The prevalence of malnutrition remains high in paediatric department in Burkina Faso. Routine screening and adequate management of malnutrition, coupled with the promotion of optimal nutritional practices in childhood, is needed to improve child healthcare.

INTRODUCTION: Les pratiques d'alimentation constituentle facteur essentiel déterminant l'état nutritionnel des enfants.L'objectif de cette étude était d'évaluer l'état nutritionnel des nourrissons âgés de 6 à 23 mois admis dans le département de pédiatrie du CHU-YO et d'identifier les facteurs associés à la malnutrition. PATIENTS ET MÉTHODE: Nous avons mené une étude transversale chez des nourrissons âgés de 6 à 23 mois admis dans le service des urgences pédiatriques au Centre Hospitalier Universitaire Yalgado Ouédraogo entre le 1er mai et le 31 juillet 2016.Les facteurs associés à la malnutrition ont été identifiés par une régression logistique. RÉSULTATS: Au total 295 nourrissons ont été inclus, à un âge moyen 13 mois(Ecart type :5,1 mois).Les prévalences de la malnutrition étaient de15% pour la malnutrition aiguë, 13% pour la malnutritionchronique et 7% pour l'insuffisance pondérale. En analyse multivariée un âge ≥ 12 mois augmentait le risque de malnutrition aiguë (Rapport de cote ajusté (RCa) : 2,3 ; Intervalle de confiance à 95% : 1,1-4,7) tandis que la connaissance de l'allaitement maternel exclusif réduisait le risque de malnutrition aiguë (RCa : 0,4 ; IC95% 0,2-0,9). De plus, un âge ≥12 mois (RCa : 0,08,IC95% : 0,03-0,22), le sexe féminin (RCa : 0.31 IC95% : 0,12-0,77) et l'absence d'interdits alimentaires (RCa : 0,13 ; IC95% : 0,05-0,3) réduisait le risque d'êtreen malnutrition chronique chez les nourrissons. CONCLUSION: La prévalence de la malnutrition carentielle reste élevée en milieu hospitalier au CHU YO. La promotion des pratiques nutritionnelles optimales du nourrisson sont nécessaires pour améliorer la prise en charge des nourrissons dans le centre.

[Primary congenital lymphedema: Milroy disease: the first case observed in the Department of Pediatrics at the University Hospital Yalgado Ouedraogo, Ouagadougou]. / Le lymphœdème congénital primaire: la maladie de Milroy: à propos du premier cas observé dans le Département de Pédiatrie du Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou.

Congenital lymphedema is the accumulation of lymphatic fluid in the child's interstitial spaces. Milroy disease is a rare, hereditary, autosomal dominant condition showing incomplete penetrance. We report the case of a 7-year old little girl with Milroy disease examined for erysipelas on congenital big right leg. A family history of large congenital member existed. Physical examination showed big oedematous right leg painful to palpation, with skin lichenification and erysipelas. Paraclinical assessment objectified cutaneous lymphedema with vascular involvement suggestive of ectasia of the right saphenous vein. Female karyotype showed no abnormalities, despite the small chromosomal rearrangements. Treatment was based on physiotherapy, bandages, compression stockings and psychotherapy. This first case in Burkina Faso testifies to the rarity of the pathology but especially to the diagnostic difficulties related to the inadequacy of paraclinical investigations.