Ethyl palmitate, an anti-chikungunya virus principle from Sauropus androgynus, a medicinal plant used to alleviate fever in ethnomedicine.

ETHNOPHARMACOLOGICAL RELEVANCE: Sauropus androgynus is a medicinal shrub used for the treatment of fever in ethnomedical traditions in various Southeast Asian countries. AIM OF THE STUDY: This study was aimed to identify antiviral principles from S. androgynus against Chikungunya virus (CHIKV), a major mosquito-borne pathogen that re-emerged in the last decade, and to unravel their mechanism of action. MATERIALS AND METHODS: Hydroalcoholic extract of S. androgynus leaves was screened for anti-CHIKV activity using cytopathic effect (CPE) reduction assay. The extract was subjected to activity guided isolation and the resultant pure molecule was characterized by GC-MS, Co-GC and Co-HPTLC. The isolated molecule was further evaluated for its effect by plaque reduction assay, Western blot and immunofluorescence assays. In silico docking with CHIKV envelope proteins and molecular dynamics simulation (MD) analyses were used to elucidate its possible mechanism of action. RESULTS: S. androgynus hydroalcoholic extract showed promising anti-CHIKV activity and its active component, obtained by activity guided isolation, was identified as ethyl palmitate (EP), a fatty acid ester. At 1 µg/mL, EP led to 100% inhibition of CPE and a significant 3 log10 reduction in CHIKV replication in Vero cells at 48 h post-infection. EP was highly potent with an EC50 of 0.0019 µg/mL (0.0068 µM) and a very high selectivity index. EP treatment significantly reduced viral protein expression, and time of addition studies revealed that it acts at the stage of viral entry. A strong binding to the viral envelope protein E1 homotrimer during entry, thus preventing viral fusion, was identified as a possible mechanism by which EP imparts its antiviral effect. CONCLUSIONS: S. androgynus contains EP as a potent antiviral principle against CHIKV. This justifies the use of the plant against febrile infections, possibly caused by viruses, in various ethnomedical systems. Our results also prompt more studies on fatty acids and their derivatives against viral diseases.

Impact of suicide mortality on life expectancy in the United States, 2011 and 2015: age and sex decomposition.

OBJECTIVES: This study examined (1) potential differences in life expectancy when suicide as a cause of death was discounted and (2) suicide's contributions to changes in life expectancy by age group and sex. METHODS: Data were from the 2011 and 2015 National Violent Death Reporting System on all suicide decedents aged 10 years or older in 17 US states. Life tables were constructed based on the total population and all-cause mortality data from the Centers for Disease Control and Prevention. Differences in life expectancy were calculated using Arriaga's decomposition method. RESULTS: The numbers of suicide deaths in both 2011 and 2015 were 3-4 times higher among males than females in all age groups. The highest impact for both males and females was in the 55-64 age group, with changes in life expectancy of 1.64 years in 2011 and 1.60 years in 2015 for men, and 1.30 years in 2011 and 1.27 years in 2015 for women. Between 2011 and 2015, the percent change in suicide mortality rates for all age groups was 7.44% in males and 15.72% in females. However, the groups that negatively impacted changes in life expectancy due to significant increases in suicide mortality were males aged 25-34 (22.80%) and 55-64 (15.45%) and females aged 15-19 (34.74%) and 55-64 (23.15%). Eliminating suicide as a cause of death would have increased life expectancy at birth by 1.92 years for males and 1.36 years for females from 2011 to 2015. CONCLUSIONS: This study updates information on suicide and adds to calls for more effective suicide prevention efforts, especially for older adolescent girls, young men, and middle-aged men and women.

Épidémiologie des accidents domestiques chez l'enfant à Dakar (Sénégal)

Introduction. Ce travail avait pour but de rapporter les aspects épidémiologiques des accidents domestiques (AD) au niveau du service de chirurgie pédiatrique de l'Hôpital d'Enfants Albert Royer (HEAR) de Dakar. Matériels et méthodes. Les dossiers d'enfants victimes de traumatismes non intentionnels survenus à domicile ou dans ses abords immédiats étaient inclus. Nous avons noté l'âge et le sexe de l'enfant, le jour et l'heure de l'accident, le mécanisme de l'accident et le lieu de survenue. Nous avons aussi étudié les types de lésions occasionnées et leur siège. Résultats. On notait une prédominance masculine avec un sexe ratio de 2,21. L'âge moyen était de de 4,2 ans et les enfants âgés de moins de 5 ans étaient les plus touchés (63,4 %). Les familles avec plus de deux enfants étaient les plus concernées (67 %). L'AD survenait le plus souvent les jours ouvrables avec un pic les mercredis (18,4 %). Près de la moitié des AD (42,2 %) étaient survenues le soir entre 17 heures et 20 heures. Les alentours de la maison étaient l'endroit le plus accidentogène (18,2 %). Les types d'accidents rencontrés ont été les suivants: les traumatismes (77,6 %), les intoxications (20,4 %) et les ingestions de corps étrangers (2 %). Les lésions les plus rencontrées étaient les fractures (46 %), suivies des traumatismes cranio-encéphaliques (22,9 %), des contusions (21,3 %) et des plaies (9,8 %). Les membres pelviens étaient la partie du corps la plus touchée (51,5 %) suivis de la tête (10,6 %). Aucun cas de décès n'avait été enregistré. Conclusion. Les AD chez l'enfant sont fréquents dans notre service et surviennent essentiellement dans les abords immédiats de la maison. Les victimes sont essentiellement les garçons de moins de 5 ans. Les fractures prédominent et siègent aux membres

[Particularities of liver abscesses in children in Senegal: Description of a series of 26 cases]. / Particularités des abcès du foie chez l'enfant au Sénégal : description d'une série de 26 cas.

UNLABELLED: Liver abscess is a serious infection that can cause life-threatening complications. OBJECTIVE: To describe the epidemiology, diagnosis, and progression of liver abscess at the Dakar National Albert-Royer Children's Hospital. METHOD: A retrospective study was conducted from over a period of 5 years (1st January 2010 to 31st December 2014). All children aged 0-15 years hospitalized for liver abscess with ultrasound confirmation were included. We collected demographic data (age, gender, socioeconomic status, origin), clinical data (general and hepatic symptoms), diagnostic data (ultrasound, bacteriology) and progression (death, complications, sequelae). The data were analyzed with Epi-info (P<0.05 was considered significant). RESULTS: We collected 26 cases of liver abscesses, representing a hospital prevalence of 100 cases per 100,000 admissions. Males predominated (sex ratio: 1.36). The children's average age was 7.2 years. Most of the children came from urban areas of Dakar. Low socioeconomic status and precarious lifestyle were the contributing factors. Anemia (69.2%), malnutrition (42.3%), and abdominal trauma (15.3%) were the main causes found. The Fontan triad characteristic of the liver abscess was found in 57.7% of cases. At ultrasound, a single abscess was found in 21 cases. The abscess was located in the right lobe in 18 cases, the left lobe in three cases, and in both lobes in three cases. Segment VI (four cases) was the most frequently involved. Bacteriologically, the abscess was pyogenic in 17 cases and an amoebic abscess in nine cases. The main pyogenic sources found were Klebsiella pneumoniae in two cases, Pseudomonas aeruginosa in one case, Streptococcus pneumoniae in one case, and Staphylococcus aureus in one case. The average duration of antibiotic treatment was 14.5 days. Liver drainage was carried out in 24 cases. The outcome was favorable in all children. CONCLUSION: The prevalence of liver abscesses at the Albert-Royer Children's Hospital is relatively high, compared to the literature data. Percutaneous drainage combined with antibiotics remains the treatment of choice. The prognosis is favorable.

[What determines the sick leave of repair and rehabilitation of the hand flexor tendons injuries]. / Recherche sur les facteurs influençant la durée de l'arrêt de travail dans les réparations des tendons fléchisseurs de la main.

OBJECTIVES: The purpose of this study is to analyse the relationship between the social and economical consequences, after repair and rehabilitation of the hand flexor tendon injuries, and to prove that it is not related to local factors. METHOD: All the patients who underwent surgery for at least one flexor tendons injury of one or several long fingers, between the years 2003-2004 were included in this study. Information regarding the data was taken from the patient file. Statistical tests were used for analysing these data. RESULTS: Significant first rate factors related to the length of sick leave are the chaotic professional history (P=0.03), the type of occupation (P=0.01) and the age (P=0.0002). A significant second rate factor is represented by the type of mobilization/retraining (P=0.04). Sex, side of injury, finger injured, zone of injury, associated damages, did not significantly influence the results of this study. CONCLUSION: The environmental factors determine the length of sick leave more than the characteristic of injury in hand flexor tendons surgery.

[Laparoscopic cholecystectomy in sickle cell disease]. / La cholécystectomie laparoscopique dans la drépanocytose.

STUDY AIM: Sickle cell affection is a public health problem in Africa. The aims of this prospective study were to evaluate the early results of laparoscopic cholecystectomy in sickle cell patients in Senegal. METHOD: From January 1998 to June 2002 all the sickle cell patients undergoing a laparoscopic cholecystectomy were included. Intra- and post-operative protocol (blood transfusion if Hb < 9 g/dl, rehydration, oxygenotherapy) was standardized. RESULTS: Forty-two patients with sickle cell of types SS-33 and AS9 were operated upon by same surgeon. One case of conversion due to an effraction of biliary junction was reported. One homozygote patient died post-operatively because of peritonitis. Two acute thoracic syndromes, three vaso-occlusive crisis, and two cases of wound infection constituted the post-operative morbidity. No case of complication was noted in those who underwent pre-operative transfusion. CONCLUSION: Laparoscopic cholecystectomy can be carried out in sickle cell patients with biliary lithiasis provided that general anaesthetic rules are respected.