[Traumatic brain injury and anterior pituitary dysfunction. Regarding 33 cases: Evolution profile over a six-month period]. / Traumatisme crânien et dysfonctionnements antéhypophysaires. À propos de 33 cas : profil évolutif sur 6 mois.

OBJECTIVES: To measure anterior pituitary dysfunction in traumatic brain injury (TBI) and assess the correlations between this disorder, clinical signs and brain lesions. METHOD: This was a prospective, longitudinal and analytic study conducted in the department of neurosurgery at the National Hospital of Niamey and the institute of radioisotopes of Niamey University between November 2009 and November 2010. All patients admitted for head trauma were included in the study. They were followed-up for 6 months and underwent clinical, hormonal and CT scan analysis. The hormonal studies targeted gonadotroph hormone, growth hormone (GH), corticotroph, lactotroph, and thyreotroph axes. RESULTS: Thirty-three patients were included in the study. The sex ratio was 15.4:1. The mean age was 28.21 years. Glasgow coma scale score was between 7 and 12 in 52% of cases, with brain contusions in 54.5% of cases. In the acute phase, hypogonadism was reported in 64% of cases, and growth hormone deficiency in 58% of cases. Hormonal follow-up at three months showed GH deficiency in 48% of cases with an elevated luteinizing hormone (LH) in 42% of cases. At sixth months, a rise in LH was observed in 55% with GH deficiency in 52% of cases. Surgical procedures were performed in 21% of cases. At 6 months a post-concussion syndrome was observed in 48.48% of cases. CONCLUSION: These pituitary dysfunctions are common and should be investigated into the management of TBI.

[Neglected idiopathic congenital clubfoot : surgical treatment before 20 years old. Retrospective study of 40 feet]. / Pied bot varus equin congenital idiopatique neglige. Traitement chirurgical avant 20 ans a propos de 40 pieds colliges sur 7 ans.

From January 2000 to december 2006, 40 club foot have been collected to the service of the frequency of the inveterate equin varus club foot is 0.3%. The average age is 12.13 years with extremes of 3 years to 20 years. The masculine sex is predominate with sex ratio of 1.08. Most patients come from the farming zones either 86.2% of the sample with parents to 93.1% without level of instruction. The bilateral attack predominates in 55% of the cases. On the therapeutic plan, ours patients benefited from the surgical technique of postero medical soft tissue release and lateral ostestomy in one time. A case of skin necrosis has been noted in our set. The middle receding is of 49 months with extremes of 14 months to 84 months. Our results were satisfactory in 95% of the cases.

Prévalence et sensibilité aux antibiotiques de Neisseria gonorrhoeae chez les professionnelles du sexe et les patients IST au Niger

Le but de l'etude etait d'estimer la prevalence des infections a Neisseria gonorrhoeae et d'evaluer la sensibilite aux antibiotiques des souches; en vue d'une revision eventuelle du traitement par approche syndromique des ecoulements genitaux au Niger. De juillet a decembre 2007; un depistage systematique a ete effectue chez des professionnelles du sexe (PS) dans 5 localites; et des patients consultant pour IST a Niamey. Parallelement a l'examen microscopique apres coloration de Gram; les prelevements endocervicaux ou uretraux ont ete mis en culture sur gelose chocolat Polyvitex (bioMerieux); avec/sans inhibiteurs VCN; en atmosphere humide; sous 5-10CO2; pendant 1 a 2 jours. Les colonies suspectes sont identifiees sur galerie API NH (bioMerieux) et les antibiogrammes realises. Le gonocoque n'a ete isole que chez 0;68(5/739) des PS. Aucune souche n'a ete obtenue chez les 20 patientes IST; contre 2 chez les 9 cas d'uretrite masculine. Chacune des souches est resistante a au moins un des antibiotiques recommande par l'OMS dans l'approche syndromique. Cinq produisent une penicillinase et 2 une beta-lactamase a spectre elargi. Avec cette relative rarete des isolats et l'existence de resistance a au moins un des antibiotiques preconises; seule une surveillance microbiologique de routine permettra une collecte suffisante de souches pour avoir des donnees fiables necessaires a une revision de protocole