Etude de la variation de l'épaisseur centrale de la cornée au cours d'une hyperglycémie de novo / Study of the variation of the central thickness of the horn during de novo hyperglycemia

Introduction : L'épaisseur centrale de la cornée peut être modifiée au cours d'une hyperglycémie chronique. En dehors d'une hyperglycémie chronique, nous pensons que les modifications de l'épaisseur cornéenne surviennent également lors des hyperglycémies de novo.Objectif: Déterminer la variation de l'épaisseur centrale de la cornée au cours d'une hyperglycémie de novo.Patients et Méthodes : Il s'agissait d'une étude observationnelle et transversale à visée analytique réalisée de juillet à novembre 2021, auprès de 222 personnes (444 yeux) présentant une hyperglycémie récente. L'ECC a été comparée entre le moment du diagnostic (J0) et 30 jours (J30) après l'initiation du traitement hypoglycémiant (Chi-2). La variation de l'ECC entre J0 et J30 a été corrélée à celle de la glycémie (Spearman ; p<0,05).Résultats : A J0, la moyenne de l'ECC était de 552,5±39,2 µm contre 538,0±34,2 µm à J30 (p=0,001) et celle de la glycémie de 18,1±8,2 mmo/L contre 6,9±3,0 mmol/L (p = 0,001). A J0, 57,0% avaient une ECC > 550µm et à J30, 19,4% avaient diminué cette épaisseur entre 520 et 550 µm et 3,4% à moins de 520 µm. Sur un effectif de 444 yeux, 28,2% (n = 125) ont diminué leur ECC de 25 µm et plus après initiation du traitement hypoglycémiant. Aucune corrélation n'existait entre la variation de l'ECC et celle de la glycémie (r=0,018; p=0,704).Conclusion : Ces résultats montrent qu'il existe une variation de l'ECC en cas de déséquilibre glycémique récent

Introduction : The central thickness of the cornea can be changed during chronic hyperglycemia. Apart from chronic hyperglycemia, we believe that changes in corneal thickness also occur during de novo hyperglycemia.Objective: To determine the variation in the central thickness of the cornea during de novo hyperglycemia.Patients and Methods: This was an observational and cross-sectional analytical study conducted from July to November 2021, involving 222 people (444 eyes) with recent hyperglycemia. ECC was compared between the time of diagnosis (D0) and 30 days (Day 30) after initiation of hypoglycemic (Chi-2) therapy. The change in ECC between J0 and J30 was correlated with that of blood glucose (Spearman ; p<0,05).Results: ON D0, the mean ECC was 552.5±39.2 µm versus 538.0± 34.2 µm on D30 ( p=0.001) and the blood glucose mean was 18.1±8.2 mmo/l versus 6.9±3.0 mmol/l ( p=0.001). On D0, 57.0% had an ECC ˃ 550µm and on D30, 19.4% had decreased this thickness between 520 and 550 µm and 3.4% to less than 520 µm. On a population of 444 eyes, 28.2% ( n=125) decreased their ECC by 25 µm and more after initiation of hypoglycemic therapy. There was no correlation between the change in ECC and the change in blood glucose (r=0.018; p=0.704).Conclusion : These results show that there is a variation in ECC in case of recent glycemic imbalance

Implementation of blanket provider-initiated testing and counselling: Predictors of HIV seropositivity among infants, children and adolescents in Cameroon.

Objectives: The number needed to test (NNT) to identify a child infected with HIV remains high in the context of the implementation of the blanket provider-initiated testing and counselling (bPITC) strategy. This study assessed the predictors of HIV seropositivity among outpatient children/adolescents (6 weeks-19 years) in Cameroon. This information is needed to improve the yield of bPITC and reduce the current gap in pediatric and adolescent ART coverage in this country and beyond. Study design: Cross-sectional study conducted in 3 hospitals in Cameroon. Methods: Through biological parents and guardians we systematically invited children and adolescents visiting the outpatient departments for any reason to test for HIV (bPITC) in a 6-month period. Children and adolescents were tested for HIV following the national guidelines and the predictors of HIV seropositivity were assessed using multivariate logistic regression at 5% significant level. Results: A total of 2729 eligible children/adolescents were enrolled. Among these, 90.3% (2465/2729) were tested for HIV. Out of these, 1.6% (40/2465) tested HIV-positive, corresponding to a NNT of 62. In multivariate analysis, HIV seropositivity was 2.5, 3.3, and 5 times more likely to be reported among children/adolescents of the female sex [aOR â€‹= â€‹0.4 (0.2-0.8), p â€‹= â€‹0.008]; whose fathers had no formal school education [aOR â€‹= â€‹0.3 (0.1-0.6), p â€‹= â€‹0.004] and those whose mothers had died [aOR â€‹= â€‹0.2 (0.0-0.9), p â€‹= â€‹0.041], respectively. Conclusions: Focusing HIV testing among female children/adolescents, whose fathers had no education level and whose mothers had died could reduce the NNT, improve the yield of bPITC and increase the pediatric and adolescent ART coverage.

Thyroid Hemiagenesis Associated with Hashimoto's Thyroiditis.

Thyroid hemiagenesis is a rare congenital anomaly resulting from failure of one thyroid lobe development. We report a 23-year-old female presented with Hashimoto's thyroiditis in left lobe, associated with hemiagenesis of right lobe and isthmus which was previously diagnosed as Graves' hyperthyroidism, but developed further into Hashimoto's thyroiditis after being treated with antithyroid drugs. The symptoms of hyperthyroidism in the current case led to the diagnostic confirmation by scintiscanning of an absent lobe. The antithyroid pharmacotherapy by thiamazole was used. However, due to symptoms of hypothyroidism, it was discontinued two months later, so thyroid hormone substitution was reintroduced. Antithyroid antibody studies and ultrasonography documented the presence of Hashimoto's thyroiditis.