Whole-body propionate and glucose metabolism of multiparous dairy cows receiving folic acid and vitamin B12 supplements.

This study was undertaken to evaluate the effect of supplementation of folic acid and vitamin B12 on glucose and propionate metabolism. Twenty-four multiparous cows were assigned according to a complete block design in a 2 × 2 factorial arrangement to one of the following treatments: (1) saline 0.9% NaCl, (2) 320 mg of folic acid, (3) 10 mg of vitamin B12, or (4) 320 mg of folic acid and 10 mg of vitamin B12. Intramuscular injections were given weekly from 3 wk before the expected calving date until 9 wk postpartum. At 63 d in milk, d-[6,6-2H2]-glucose (16.5 mmol/h; jugular vein) and [1-13C]-sodium propionate (13.9 mmol/h; ruminal vein) were simultaneously infused for 4 h; blood samples were collected from 2 to 4 h of the infusion period. Liver biopsies were carried out the following day. Supplements of folic acid and vitamin B12 respectively increased folate and vitamin B12 concentrations, both in milk and liver. Although dry matter intake was unaffected by treatments, milk and milk lactose yields tended to be lower by 5.0 and by 0.25 kg/d, respectively, for cows receiving the folic acid supplement. Plasma ß-hydroxybutyrate concentration with the folic acid supplement followed the same tendency. Hepatic gene expression of methylmalonyl-CoA mutase and S-adenosylhomocysteine hydrolase was higher for cows receiving the combined folic acid and vitamin B12 supplement compared with cows receiving only the supplement of folic acid, whereas no treatment effect was noted for cows not receiving the folic acid supplement. Whole-body glucose rate of appearance and the proportion of whole-body glucose rate of appearance secreted in milk lactose decreased by 229 g/d and 5%, respectively, for animals receiving the folic acid supplement, concomitant with the lower milk lactose synthesis in these cows, indicating that supplementary folic acid may alter energy partitioning in cows. The absence of treatment effect on plasma concentrations of methylmalonic acid as well as on the proportion of glucose synthesized from propionate, averaging 60%, supports the fact that vitamin B12 supply was sufficient in control cows in the current study. Our results suggest that the folic acid supplement reduced glucose-derived lactose synthesis by redirecting glucose for other metabolic activity in the mammary gland or in other tissues.

[Sacroiliac joint disorders in Abidjan: epidemiological, clinical, radiological and etiological characteristics]. / Atteintes sacroiliaques à Abidjan: aspects épidémiologiques, cliniques, radiologiques et étiologiques.

BACKGROUND: The sacroiliac joint remains unknown in sub-Saharan Africa. Studies about the sacroiliac diseases are rare Aim : Describe the epidemiological, clinical, radiological and etiological characteristics of sacroiliac joint diseases in Abidjan Methods : Retrospective and descriptive study concerning 17 patients hospitalized from February 2003 to April 2010 in the department of rheumatology of university hospital center of Cocody (Abidjan) for buttock pain or others functional signs evoking sacroiliac joint which were attested by radiographic lesions. We were interested on the epidemiological, clinical and radiological characteristics and the etiologies in the sacroiliac disease. RESULTS: The hospital prevalence of sacroiliac diseases was 0.55% corresponding in 17 of 3067 rheumatological diseases. The female sex predominated (82.35%) and the mean age of 25.58 years. Gyneco-obstetric events were the predominant risk factors (47.05%). Sacroiliac damage was manifested by inflammatory pain (64.7%) localized at the buttock or lumbar spine, radiating to the thigh (52.9%) and was accompanied by functional disability (82.2%) and fever was not present every time (64.7%). The physical findings were the tripod sign positive (58.8%), the monopodal backing positive (41.2%) and palpation painful of sacroiliac joint. The standard radiograph revealed a blurring aspect and widening of joint space associated with demineralization (68.4%), a joint space narrowing and erosion of articular banks (23.5%). The etiologies found were bacterial arthritis (82.3%) mainly pyogenic (70.58%), osteoarthritis (11.7%) and ankylosing spondylitis (5.9%). CONCLUSION: Sacroiliac joint diseases are rare in rheumatology practice in Abidjan, concern younger subjects and are dominated by pyogenic sacroiliitis.

[Clinical, biological, therapeutic and evolving profile of patients with HIV infection hospitalized at Infectious and tropical diseases unit in Abidjan (Ivory Coast)]. / Profil clinicobiologique, thérapeutique et évolutif des patients infectés par le VIH hospitalisés au service des maladies infectieuses et tropicales d'Abidjan (Côte d'Ivoire).

The objective of this study is to describe the clinical, biological, therapeutic and evolving current profile of hospitalized patients with HIV infection in the cohort of the Infectious and Tropical Diseases Unit (ITDU) in the aim to improve their care management. This is a retrospective study, conducted on medical data of hospitalized cases of patients with HIV infection in the ITDU at the teaching hospital of Treichville (Abidjan) from 2006 to 2007. During the two years, 447 patients were included in the study. Their average age was 39 years [18 years-86 years] and sex ratio was 0.69. Of the 447 patients, 35% were unemployed and 67% were new patients who had never undergone antiretroviral therapy (ART). The duration of drug exposure was less than 6 months in 59% of treated patients. The average time to initiate ART was seven weeks. Among naive patients 41.9% were lost to follow up, 35.9% were waiting for treatment and 22.1% waiting for baseline biological test to initiate ART. At the initiation of ART, 79.6% of patients had a CD4 count less than 200/mm(3). The reasons of hospitalization defining AIDS were dominated by tuberculosis (34.2%), cerebral toxoplasmosis (17.9%) and neuromeningeal cryptococcosis (8%). The main reasons of hospitalization in classifying non-AIDS were pyelonephritis (6.5%), bacterial pneumonia (5.4%) and undetermined infectious encephalitis (4.9%). Hospital mortality was 24.4%. The leading causes of death were tuberculosis (22.9%), cerebral toxoplasmosis (20.2%), undetermined infectious encephalitis (18.3%) and cryptococcal meningitis (13.7%). The profile of PLHIV in hospital is characterized by profound immunosuppression due to late diagnosis and high mortality associated with severe opportunistic infections and late initiation of ART.

Kidney biopsy in subsaharan Africa / Ponctions biopsies rénales en Afrique subsaharienne

Materials and methods: We carried out a retrospective and descriptive study on biopsies examined between January 2015 and December 2019, in the pathological departments of University Teaching Hospital of Bouaké and Cocody-Abidjan. The KB came from four countries (Côte d'Ivoire, Togo, Guinea-Conakry and Burkina Faso). Optical microscopy and/or direct immunofluorescence techniques were used. All biopsy samples including epidemiological, clinical and pathological data and an optical microscopy and/or direct immunofluorescence study were included. The parameters studied were indications for KB, epidemiological profile, clinic, proteinuria and pathological aspects. Results: Over the study period, we collected 179 KB, i.e. 35.8 KB/year. The mean age of the patients was 32.9 ±13.8 years (range 11-70 years). The sex ratio (M/F) was 1.03. Pure nephrotic syndrome was the main indication (64.2 %, n = 115) for KB, followed by impure nephrotic syndrome (11.7 %, n = 21), acute renal failure (ARF) (7.8 %, n = 14) and rapidly progressive glomerulonephritis (RPGN) (7.8 %, n = 14). Glomerulonephritis (GN) occurred in 86 % (n = 158), vascular nephropathy in 11.7 % (n = 21) and tubulointerstitial nephritis in 2.2 % (n = 4). The nephropathies were preferentially focal segmental glomerulosclerosis (34.6 %, n = 62), nephroangiosclerosis (10.6 %, n = 19), membranous GN (10 %, n = 18), post-infectious GN (8.9 %, n = 16) and lupus GN (7.3 %, n = 13). Conclusion: The KB is an essential step in the diagnosis of nephropathies. Focal segmental glomerulosclerosis is frequent in our study. The establishment of a Kidney registry would allow better knowledge of renal pathologies in sub-Saharan Africa.

La ponction biopsie rénale (PBR) constitue une avancée notable dans la prise en charge des néphropathies. En Afrique subsaharienne, peu d'études ont été réalisées. L'objectif de notre travail était d'évaluer les indications de la PBR et de déterminer les caractéristiques épidémiologiques et histologiques des néphropathies diagnostiquées en Afrique subsaharienne. Matériels et méthodes: Nous avons mené une étude rétrospective et descriptive portant sur les PBR examinées entre janvier 2015 et décembre 2019, dans les services d'anatomie et cytologie pathologiques des CHU de Cocody-Abidjan et de Bouaké. Les PBR provenaient de quatre pays africains (Côte d'Ivoire, Togo, Guinée-Conakry et Burkina Faso). Les techniques de microscopie optique et/ou d'immunofluorescence directe ont été utilisées. Nous avons inclus l'ensemble des PBR contributives sur cette période et pour lesquelles nous disposions de données cliniques et biologiques. Les paramètres étudiés étaient les données cliniques et biologiques, l'indication de la PBR et les résultats histologiques. Résultats: Sur la période d'étude, nous avons colligé 179 PBR, soit 35,8 PBR/an. L'âge moyen des patients était de 32,9 ± 13,8 ans (extrêmes de 11 à 70 ans). Le sex ratio (H/F) était de 1,03. Le syndrome néphrotique pur était la principale indication (64,2 %, n = 115) à la réalisation d'une PBR, suivi du syndrome néphrotique impur (11,7 %, n = 21), de l'insuffisance rénale aiguë (IRA) (7,8 %, n = 14) et de la glomérulonéphrite rapidement progressive (GNRP) (7,8 %, n = 14). Les glomérulonéphrites (GN) s'observaient dans 86 % des cas (n = 158), les néphropathies vasculaires dans 11,7 % (n = 21) et les néphrites tubulo-interstitielles dans 2,2 % (n = 4). Les néphropathies les plus fréquentes étaient la hyalinose segmentaire et focale (34,6 %, n = 62), la néphroangiosclérose (10,6 %, n = 19), la GN extramembraneuse (10 %, n = 18), la GN post-infectieuse (8,9 %, n = 16) et la GN lupique (7,3 %, n = 13). Conclusion: La PBR est un geste capital pour le diagnostic des néphropathies. La hyalinose segmentaire et focale est la principale nosologie retrouvée dans notre cohorte. La mise en place d'un registre Rein permettrait une meilleure connaissance et prise en charge des pathologies rénales en Afrique subsaharienne.

[Current aspects of neuromeningeal cryptococcosis in adults infected with HIV in the internal medicine service of the University Hospital of Treichville Abidjan (Cote d'Ivoire)]. / Aspects actuels de la cryptococcose neuroméningée chez des sujets adultes infectés par le VIH dans le service de médecine interne du CHU de Treichville d'Abidjan (Côte d'Ivoire).

OBJECTIVES: To determine the prevalence of neuromeningeal cryptococcosis (NMC) and reporting sociodemographic, clinical, paraclinical aspects and outcome of patients. METHODS: It was a retrospective study concerning 22 HIV positive patients hospitalized between 2006 to and 2009 in the internal medicine service of University Hospital of Treichville for NMC. RESULTS: The prevalence of NMC in patients infected with HIV was 0.6%. The mean age was 35±4.5 years old. The sex-ratio was 0.5. The average time evolution of the symptomatology was 10±2.1 days. The installation of the disease was progressive (86.4%). The main signs were fever (100%) and headache (95.4%). The cerebrospinal fluid was inflammatory aspect (95.4%) with low glucose (91%), hyper lymphocytosis(100%). There were Cryptococcus neoformans in direct exam by China ink (72.7%) and culture on Sabouraud (100%). Treatment was injectable amphoterin B in monotherapy (54.5%) followed by fluconazole per os (45.5%). The mortality was 54.5%. CONCLUSION: This study shows a reduction of NMC prevalence in our service in relation with tritherapy.

[Utility of the viral load measurement after one month of antiretroviral treatment]. / Intérêt de la mesure de la charge virale au premier mois du traitement antirétroviral.

OBJECTIVE: To evaluate the therapeutic utility of the viral load (VL) measurement after one month (M1) of antiretroviral (ARV) treatment. PATIENTS AND METHOD: A retrospective study of HIV patients included in the NADIS database from 1998 to 2006 and followed at Nice University Hospital. We included ARV-naive patients who received ARV (3-drug combination) for at least 3 months and ARV-experienced patients beginning a new ARV after virologic failure. RESULTS: The NADIS database included 1065 patients from 1998 to 2006. We included 262. In all, 234 of them had VL measured at M1 and are considered in this analysis. Their mean age was 44 years, and 174 were men, for a sex ratio of 9.1. ARV-naïve patients accounted for 35% of the sample (n = 81) and previously treated patients 65% (n = 153). All the naive patients had a VL decrease at M1 > 1 log, as did all but 14 of the previously treated patients (9%). This virological result was followed by a medical action 21 times for the naive patients and 97 times for the previously treated patients (p < 0.004). CONCLUSION: The VL measurement at M1 indicates a virological objective that was reached for all the naive patients and 91% of the previously treated patients. Moreover, the medical actions taken at M1 for a new ARV treatment appear to be associated with the patient's treatment history and not the virological results.

Familial aggregation in giant cell arteritis and polymyalgia rheumatica: a comprehensive literature review including 4 new families.

OBJECTIVE: To review personal and published observations of giant cell (temporal) arteritis (GCA) or polymyal-gia rheumatica (PMR) with familial or conjugal aggregation and emphasise on epidemiological, clinical and genetic features of such cases. METHODS: We pooled data obtained from all cases of GCA or PMR with familial aggregation recruited in the department since 1976 and those from reports of familial or conjugal GCA or PMR published in the French-English literature since 1970. RESULTS: During the study period, we diagnosed 460 patients (128 with isolated PMR, 227 with isolated GCA, 105 with PMR/CGA). No conjugal couples were observed in the whole series. No familial cases were identified among PMR patients, whereas the prevalence of familial GCA was 1 in 83 (1 in 250 to 500 expected by chance), as we identified 4 patients (brother-brother, sister with history of affected sister, and daughter with priory affected mother). An additional pair of sisters with TA, recruited several months after diagnosis, is also presented. Pooling data from 85 patients (74 with GCA) including our patients, representing 32 families and 8 conjugal pairs, enabled us to draw the following observations: 1) partial or full agreement in the clinical picture (GCA, PMR, or GCA/PMR) was observed in 96% of the siblings pairs, suggesting a common pathogenic mechanism; 2) five kindred were described in whom at least three members were affected; 3) the lag between manifested diseases in familial or conjugal pairs averaged 5.7 years, with synchronous or close disease occurrence in only 26% of the pairs; 4) 18 of 32 assessed patients (56%) carried the DR4 antigen. CONCLUSION: Our survey on familial aggregation of GCA and PMR accumulated data pointing to a genetic predisposition. However, environmental contagious factors could have trigger synchronous disease onset in up to one-fourth of the cases.

[Cerebral thrombophlebitis: parotidectomy complication in a child]. / Thrombophlébite cérébrale: complication d'une parotidectomie chez un enfant.

INTRODUCTION: Onset of cerebral thrombophlebitis following parotidectomy in a child is reported. OBSERVATION: A seven-year-old boy presenting apparently benign tumefaction in the right parotid gland area had undergone a conservative right total parotidectomy. The histological examination of the operative specimen suggested a diffuse neurofibroma as part of a clinical picture of Recklinghausen's neurofibromatosis. The immediate postoperative follow-up was marked by a pyramidal syndrome in the left hemibody, with the CT scan showing thrombophlebitis. After treatment combining an anticoagulant, a vasodilator and an antibiotic, the patient progressed toward partial recovery of left hemibody motor activity. COMMENTS: This cerebral vascular accident is related to the angiodysplasia encountered in Recklinghausen's disease. Anticoagulants initialized rapidly are the only demonstrated therapy to improve the prognosis in this type of complication.

[Lumbar nerve root pain with fever in tropical area: posterior spinal tuberculosis]. / Lomboradiculalgies fébriles en zone tropicale: atteinte tuberculeuse de l'arc vertébral postérieur.

The purpose of this report is to describe the case of tuberculosis osteitis of the posterior vertebral arch in a 35-year-old man with recent history of pulmonary tuberculosis. Clinical findings were pain due to bilateral inflammation of the lumbar nerve roots, fistulised cold abcess and motor deficit in both lower extremities. The tomodensitometry demonstrated a lytic bone lesion involving the spinous process of the second lumbar vertebra in association with spondylitis and a large paravertebral abscess with calcification typical of tuberculosis. Cure was achieved by a single 12-month course of appropriate treatment.

Aspects épidémiologiques, cliniques, thérapeutiques et évolutifs des maladies thyroïdiennes à Bouaké (Côte d'Ivoire) / Epidemiological, clinical, therapeutic and evolutionary aspects of thyroid deseases in Bouake (Ivory Coast)

Contexte : la maladie thyroïdienne représente la plus fréquente endocrinopathie dans le monde après le diabète sucré. En Afrique, elle constitue un véritable problème de santé publique et sa prise en charge est souvent entravée par les moyens d'investigations. Le but était d'étudier le profil des affections thyroïdiennes à Bouaké. Méthodes : il s'agissait d'une étude rétrospective, descriptive, menée dans le service de consultation de Médecine Interne du Centre Hospitalier Universitaire de Bouaké du 1er janvier 2020 au 31 décembre 2021. Elle a porté sur les dossiers de 104 patients suivis pour une pathologie thyroïdienne. Résultats : Sur 2560 patients reçus, la pathologie thyroïdienne concernait 104 patients ; soit une fréquence de 4,1%. Il s'agissait de 93 femmes et 11 hommes avec un sex-ratio (H/F) de 0,12 L'âge moyen était de 42,03 ans ±15 ans. Dans plus de la moitié des cas (55,8%), le délai de consultation était supérieur à 06 mois. Sur le plan fonctionnel, 58 patients (55,8%) présentaient une hyperthyroïdie avec comme principales étiologies la maladie de Basedow (60,3%, n=35) et le goitre multinodulaire toxique (24,1%, n=14). L'hypothyroïdie était retrouvée chez 10 patients (9,6%), le plus souvent post thyroïdectomie (60%). Les goitres et nodules euthyroïdiens étaient retrouvés chez 36 patients (34,6%) dominés par le goitre multinodulaire euthyroïdien (36,1%, n=13) et le goitre simple (27,8%, n=10). Le traitement des hyperthyroïdies reposait essentiellement sur les antithyroïdiens de synthèse dans 96,7%. Seulement 1 patient hyperthyroïdien avait subi une thyroïdectomie. La majorité des patients (82,2%) étaient perdus de vue. Conclusion : La pathologie thyroïdienne au CHU de Bouaké est une maladie fréquente de la femme jeune. Les hyperthyroïdies dominent le tableau des thyréopathies avec comme principale étiologie la maladie de Basedow. On note un taux élevé de perdu de vue, d'où l'intérêt d'une éducation de nos patients.

Context: Thyroid disease is the most common endocrinopathy observed in the world. In Africa, thyroid diseases remain a real public health problem and their care is often hampered by the means of investigation. The purpose of this work was to study the profile of thyroid affections in Bouake. Methods: This was a descriptive study with retrospective data collection, carried out over the period from 1 January 2020 to 31 December 2021 at the Internal Medicine consultation at the University Hospital of Bouake. All epidemiological, clinical and therapeutic and evolutionary data from patients followed for thyroid pathology were collected. It focused on the records of 104 patients followed for thyroid disease. Results: Out of a total of 2560 consultations, 104 patients were involved in thyroid pathology, prevalence of 4.1%. They were 93 women and 11 men with a sex ratio of 0.12. The average age was 42.03±15.64 years. In more than half of the patients (55.8%) the evolution of the clinical symptomatology was more than six months. A total of 58 patients (55.8%) had hyperthyroidism. The etiologies of hyperthyroidism were dominated by Grave's disease and toxic multinodular goiter, with 60.3% and 24.1% of hyperthyroidism respectively. Hypothyroidism was confirmed in 10 patients (9.6%), among then 6 (60%) had undergone total thyroidectomy. The multinodular goiter was found in 36 patients and was dominated by multinodular goiter (36.1%) and single goiter (27.8%). The treatment of hyperthyroidism was exclusively with synthetic antithyroid drugs. Hypothyroidism was treated with hormone replacement therapy. The majority of patients (82.2%) were lost in view. Conclusion: The thyroid pathology at the University Hospital Center of Bouake is a frequent illness of the young woman. Hyperthyroidism were frequently found with as main etiology Grave's disease The majority of patients (82.2%) were lost in view hence the interest of patient's education.

[Prevalence of HBs antigen in blood donors in the Bouaké regional centre of blood transfusion in 2001]. / Prévalence de l'antigène HBs chez les donneurs de sang au centre régional de transfusion sanguine de Bouaké (Côte d'lvoire) en 2001.

A prospective cross-sectional study was conducted in the regional center of blood transfusion in Bouaké from December 1, 2001 to February 28, 2002. One thousand two hundred thirty one new blood donors were tested. HBs Antigen detection was made according to ELISA technique (Hepanostika HBs Ag Uni-Form II). HBs Antigen prevalence in blood donors in Bouaké was 12.5%. One hundred fifty four blood donors were tested positive and were divided into 131 males (85%) and 23 females (15%). Their average age was 27, 5 years old (18-65 years). HBs Antigen carriage rate was lower in females and students. They were mainly pupils (62%) and had risk factors of hepatitis B infection (intramuscular injection, multiple sexual partners, unsafe sex). HBs Antigen carriage rate in blood donors is high in Bouaké and justifies the systematic screening of this Antigen in any blood donor to reduce the transfusion risk. On the other hand, it is necessary to modify the blood collection strategy in order to make the most of the donation and to decrease the residual risk.

[Multinodular goitre with widespread vasculitis of thyroid arteries revealing temporal giant cell arteritis]. / Goitre multinodulaire et artérite à cellules géantes intrathyroïdienne diffuse révélatrice d'une maladie de Horton.

We describe a 62-year-old woman with slowly growing usual nodular goitre in whom diffuse giant cell arteritis (GCA) of the thyroid arteries was found upon thyroidectomy, revealing otherwise unsuspected biopsy-proven temporal arteritis. To our knowledge, this association had been previously reported in only three instances. In each case, GCA of the thyroid arteries appeared clinically silent, did not produce significant glandular dysfunction, and was uncovered thanks to a planned thyroidectomy for nodular goitre. These observations highlight that thyroid artery involvement by GCA, even widespread, as in our patient, may be overlooked clinically and may produce little or no thyroid dysfunction.

Actualités au cours de l'évolution de l'infection à VIH sida dans un centre de référence: à propos de 327 cas colligés dans le service de médecine interne du CHU de Bouake, Côte d'Ivoire / News during the evolution of HIV/AIDS infection in a reference center about 327 cases collected in the internal medicine department of the Bouake teaching hospital, Ivory Coast

Introduction : Les maladies opportunistes surviennent chez les personnes vivant avec le VIH (PvVIH) dans les situations de prise en charge tardive. En absence de traitements efficace, la multiplication du virus est inévitable et les personnes concernées sont confrontées à une baisse de leur immunité [1]. C'est dans cette situation que des infections opportunistes se déclarent. Objectif: contribuer à une meilleure connaissance des affections opportunistes liées au VIH Méthode : L'étude s'est déroulée dans le service de Médecine Interne du CHU de Bouaké du 1er janvier 2017 au 31 décembre 2020. C'était une étude rétrospective et transversale qui a concerné les dossiers de patients infectés par le VIH hospitalisés dans ledit service. Résultats : L'analyse a noté 327 cas de dossiers complets sur 3815. La prévalence hospitalière était de 8,5%. L'âge moyen était de 36,2 ans et le sex ratio de 0,83. 65,3% des patients n'ont découvert leur statut sérologique que pendant l'hospitalisation dont les motifs étaient dominés par l'altération de l'état général (36,8%) suivi du coma (19,2%). 84,5% des patients avaient le VIH1. Le taux moyen de CD4 était de 50,5% cellules/mm3 . Les affections opportunistes étaient dominées par la tuberculose (41,8% des cas) et la plus létale était la maladie de Kaposi digestif dans 100% des cas. Conclusion: les patients étaient hospitalisés au stade d'altération de l'état général et de coma d'où la forte létalité. La tuberculose était la principale affection opportuniste. Ces résultats montrent avec beaucoup d'intérêt l'importance de la sensibilisation de la population sur le VIH et la nécessité du dépistage précoce.

Introduction: Opportunistic diseases occur in people living with HIV (PvHIV) in situations of late treatment. In the absence of effective treatments, the multiplication of the virus is inevitable and the people concerned are confronted with a drop in their immune defenses [1, 2]. It is in this situation that opportunistic infections occur Objective: to contribute to a better understanding of opportunistic infections linked to HIV. Method: The study took place in the Internal Medicine department of the Bouake University Hospital from January 1, 2017 to December 31, 2020. It was a retrospective and cross-sectional study which concerned the files of patients infected with HIV hospitalized in the said department. Results: The analysis noted 327 cases of complete records out of 3815. The hospital prevalence of 8.5%. The mean age was 36 years and the sex ratio 0.83. 65.3% of patients only discovered their serological status during hospitalization, the reasons for which were dominated by deterioration in general condition (36%) followed by coma (19.2%). 84.5% of patients had HIV1. The average CD4 count was 50.5% cell/mm3. Opportunistic diseases were dominated by tuberculosis (38% of cases) and the most lethal was digestive Kaposi in 100% of cases. Conclusion: Most of our patients were without social security and did not know their HIV status. These patients were hospitalized at the stage of impaired general condition and coma, hence the high lethality observed. The main opportunistic infections were tuberculosis, cerebral toxoplasmosis and digestive mycoses. These results show with great interest the importance of sensitizing the general population on HIV AIDS and the need for early detection of these opportunistic diseases.

Insuffisance rénale chronique: aspects épidémiologique, diagnostique, thérapeutique et évolutif au CHU de Bouaké de 2016 à 2020 / Epidemiological aspects, diagnosis features and therapeutic outcome of chronic kidney disease at the Teaching Hospital of Bouake from 2016 to 2020

Le profil épidémiologique de l'insuffisance rénale chronique (IRC) varie d'un pays à un autre et d'une région à une autre dans un même pays. L'objectif de la présente étude était de décrire les cas d'IRC observés dans la ville de Bouaké. Méthodes : il s'agissait d'une étude rétrospective réalisée dans le service de Médecine Interne du CHU de Bouaké durant la période allant du 1er Janvier 2016 au 31 Décembre 2020. L'IRC était définie par un DFG inférieur à 60 ml/minute évoluant depuis plus de trois mois et/ou une atrophie rénale. Résultats : nous avons recensé 150 cas donnant une prévalence hospitalière de 3,6%. L'âge moyen était de 38,8±10 ans avec une prédominance masculine. Les antécédents étaient dominés par l'automédication traditionnelle et l'hypertension artérielle dans 68% des cas chacun. Dans 91% des cas, l'IRC était classée grade 5. Les étiologies étaient dominées par l'hypertension artérielle (34%). Le traitement symptomatique était la transfusion dans 73% et l'usage des antihypertenseurs dans 73%. Le traitement de suppléance était indiqué dans 91% et réalisé dans 3%. La mortalité était de 25%. Les facteurs associés à la survenue du décès étaient une altération de l'état général, une hypercréatininémie, une hyperphosphorémie, des reins atrophiés et le recours à la transfusion sanguine. Conclusion: l'IRC était diagnostiquée à un stade sévère. La principale cause était l'hypertension artérielle. La mortalité demeure élevée, faute d'accès au traitement de suppléance. L'accent doit être mis sur la prévention de l'IRC au cours des pathologies à risque.

Background: The epidemiological profile of chronic kidney disease (CKD) varies from country to country and from region to region within, even in the same country. The objective of this study was to describe the cases of CKD found in the city of Bouake (Ivory Coast). Methods: We proceeded to a retrospective study carried out in the Internal Medicine department of the Bouake University Hospital from January 1, 2016 till December 31, 2020. CKD was defined by a GFR (Glomerular Filtration Rate) at less than 60 ml/ minute and small kidneys. Results: In all , we identified 150 cases corresponding to 3.6% as hospital prevalence . The mean age was 38 .8 ± 10 years with a male predominance. The history was dominated by traditional self-medication and high blood pressure (HBP) for respectively 68% of cases. In 91% of cases , the CKD was classified as grade 5. The etiologies were dominated by HBP (34%). The care was a symptomatic one using transfusion in 73% and antihypertensive medication was prescribed for 73% of the patients. The substitution treatment was indicated in 91% of cases and carried out in 3%. The rate of mortality was 25 % and factors associated with death were a deterioration of the general condition, increased of blood level of creatininemia, hyperphosphatemia, small size of kidneys and the use of blood transfusion. Conclusion: CKD was diagnosed at a severe stage. The main cause was high blood pressure. Mortality remains high due to lack of access to replacement therapy . Emphasis should be placed on the prevention of CKD in high-risk pathologies

Maladies auto-immunes systémiques dans les Services de Médecine Interne et de Dermatologie du Centre Hospitalier Universitaire de Bouaké: profil de 50 patients / Systemic autoimmune diseases in the Internal Medicine and Dermatology Departments of the University Hospital of Bouake: profile of 50 patients

Introduction Les maladies auto-immunes systémiques (MAIS) sont peu connues malgré les progrès diagnostiques et thérapeutiques réalisés ces dernières années. L'objectif de ce travail était de décrire le profil épidémiologique, diagnostique et thérapeutique des MAIS dans les services de Médecine Interne et de Dermatologie du Centre Hospitalier Universitaire de Bouaké (CHU). Méthodes Il s'agissait d'une étude transversale descriptive réalisée dans les services de Médecine Interne et de Dermatologie du CHU de Bouaké, sur une période de 10ans (janvier 2009- décembre 2018). Résultats : Sur 30906 patients, 50 présentaient une MAIS soit une prévalence hospitalière de 0,16%. Les MAIS les plus fréquentes étaient le lupus érythémateux systémique (50%) et la sclérodermie systémique (42%). L'âge moyen était de 39,5ans ±15ans et le sex-ratio de 0,19. Le délai moyen de consultation était de 26,2 mois. Le tableau clinique était dominé par les signes généraux (98%), les manifestations cutanéomuqueuses (96%) et les manifestations articulaires (90%). Chez 37 patients ayant réalisé l'hémogramme, l'anémie représentait 51,3% des cas. Le syndrome inflammatoire était objectivé chez 67% des 12 patients possédant un bilan inflammatoire. Les auto-anticorps réalisés chez 05 patients étaient contributifs chez 03 patients. Les corticoïdes par voie générale étaient prescrits dans 56% des cas et les perdus de vue étaient observés dans 90% des cas. Conclusion : Les MAIS étaient rares dans notre étude, dominées par le lupus érythémateux systémique et la sclérodermie systémique. L'amélioration du plateau technique et l'accessibilité du bilan immunologique et la sensibilisation paraissent indispensables afin d'améliorer la prise en charge des patients.

Introduction: Systemic autoimmune diseases (SAID) are little known despite the diagnostic and therapeutic progress made in recent years. The objective of this work was to describe the epidemiological, diagnostic and therapeutic profile of SAID in Internal Medicine and Dermatology departments of the university hospital of Bouake. Methods: This was a cross-sectional study carried out in the Internal Medicine and Dermatology departments of the university hospital of Bouake, over a period of 10 years (January 2009-December 2018). Results: Of 30,906 patients, 50 presented SAID with a hospital prevalence of 0.16%. The most common SAID were systemic lupus erythematosus (50%) and systemic sclerosis (42%). The mean age was 39.5 ± 15 years, and the sex ratio was 0.19. The average consultation time was 26.2 months. The clinical picture was dominated by general signs (98%), mucocutaneous manifestations (96%) and articular manifestations (90%). In 25 patients who performed the blood count, anemia represented 76% of cases. The inflammatory syndrome was objectified in 67% of the 12 patients with an inflammatory profile. The auto-antibodies made in 05 patients were contributory in 03 patients. Systemic corticosteroids were prescribed in 56% of cases and patients were lost to follow-up in 90% of cases. Conclusion: SAID were rare in our study, dominated by systemic lupus erythematosus and systemic scleroderma. Improvement of the technical platform and accessibility of the immunological assessment appears essential in order to improve patient's care.

Etiologies des fièvres prolongées inexpliquées au Service de Médecine Interne du CHU de Bouaké (Côte d'Ivoire) / Causes of unexplained prolonged fever in the Bouake CHU Internal Medicine Department (Ivory Coast)

Objectif : déterminer les étiologies des fièvres prolongées inexpliquées au service de médecine interne du CHU de Bouaké. Matériel et méthodes : Il s'agissait d'une étude rétrospective à visée descriptive mené de janvier 2019 à décembre 2020. Nous avons inclus les patients hospitalisés pour fièvre prolongée inexpliquée ou ayant présentés une fièvre prolongée durant l'hospitalisation. Les données anamnestiques, cliniques et paracliniques ont été analysées. Résultats : Nous avons retenus 204 patients sur 1650 patients hospitalisés (12,6%). L'âge moyen des patients était de 32±16,1 ans avec des extrêmes de 16 et 87 ans. Le sexe ratio était de 1,1. La fièvre (32,4%) et AEG (22%) constituaient les motifs d'hospitalisation les plus fréquents. La fièvre était le plus fréquent des symptômes physiques (94,1%) suivi de l'amaigrissement (50%), de la déshydratation (18,1%), de l'hépatomégalie (12,7%) et de l'obnubilation (12%). Les principales étiologies étaient les infections (82,3%), les tumeurs (10,3%), et les maladies inflammatoires (1,5%). Dans 5,9% des cas l'étiologie n'avait pas été retrouvée. Les principales infections étaient le VIH et ses complications (38,1%), la tuberculose (21,4%), et les infections urogénitales (19,9%). Les tumeurs étaient dominées par le cancer primitif du foie (33,4%) et le cancer de la prostate (19,4%). La polyarthrite rhumatoïde, le lupus érythémateux disséminé et la sclérodermie étaient maladies inflammatoires retrouvées. La létalité était de 36%. Conclusion : Les étiologies des fièvres prolongées inexpliquées sont variées. Elles sont dominées dans notre contexte par la tuberculose, l'infection à VIH et ses complications infectieuses.

Head-and-neck swelling: an under-recognized feature of giant cell arteritis. A report of 37 patients.

OBJECTIVE: To describe the frequency of occurrence and characteristics of head-and-neck swelling (HNS) in temporal (giant cell) arteritis (TA). METHODS: We analyzed the charts of patients with HNS retrieved from a single department series of 260 consecutive patients with TA and reviewed the published French-English literature. Patients with a swelling limited to the temporal fossa were excluded. RESULTS: A history of HNS was elicited in 17 patients in our series (i.e. 6.5%) and in 20 previously published patients. The swelling was an inaugural feature in most cases and was often transient. Ear-nose-and-throat (ENT )symptoms were observed in 80% of the cases, including jaw claudication or pain upon opening mouth in 22, causing trismus in 10. Two patients had permanent visual impairment and 1 had sudden hearing loss. The temporal artery biopsy yielded giant cell arteritis (GCA) in all the patients but 2. The HNS was often painful and mainly involved mainly the orbital region and face, particularly the lower part of the cheeks and maxillae, less often the neck and, rarely, the forehead and tongue. Concurrent localized limb swellings were also observed in 3 patients. The HNS disappeared in all the patients, either spontaneously or under steroid treatment, and recurred only in 6 patients. CONCLUSION: HNS is not exceptional in untreated TA and is strongly associated with ENT symptoms and a positive TAB, but not with visual loss or stroke. Such characteristics imply in these cases a prominent, widespread involvement of the external carotid artery system by giant cell arteritis.

Combined effect of antimicrobial coating and gamma irradiation on shelf life extension of pre-cooked shrimp (Penaeus spp.).

The present study was conducted to evaluate the combined effect of low-dose gamma irradiation and antimicrobial coating on the shelf life of pre-cooked shrimp (Penaeus spp.). Antimicrobial coatings were obtained by incorporating various concentrations of thyme oil and trans-cinnamaldehyde in coating formulations prepared from soy or whey protein isolates. Coated shrimps were stored at 4 +/- 1 degrees C under aerobic conditions and were periodically evaluated for aerobic plate counts (APCs) and Pseudomonas putida. Sensory evaluations were performed for appearance, odor, and taste using a hedonic test. Results showed that gamma irradiation and coating treatments had synergistic effects (p < or = 0.05) in reducing the APCs and P. putida with at least a 12-day extension of shelf life. Without irradiation, the inhibitory effects of the coating solutions were closely related to the concentration of thyme oil and trans-cinnamaldehyde. No detrimental effects of gamma irradiation on organoleptic parameters (appearance, odor, and taste) were observed. However, incorporation of thyme oil and trans-cinnamaldehyde reduced the acceptability scores for taste and odor.

Antibacterial activity of selected fatty acids and essential oils against six meat spoilage organisms.

The antibacterial activity of selected fatty acids and essential oils was examined against two gram-negative (Pseudomonas fluorescens and Serratia liquefaciens) and four gram-positive (Brochothrix thermosphacta, Carnobacterium piscicola, Lactobacillus curvatus, and Lactobacillus sake) bacteria involved in meat spoilage. Various amounts of each preservative were added to brain heart infusion or MRS (deMan, Rogosa and Sharpe) agars, and the minimum inhibitory concentration was determined for each organism. Essential oils were analysed by gas-liquid chromatography to determine the concentration of selected components commonly found in spices. B. thermosphacta, P. fluorescens and S. liquefaciens were not affected by fatty acids, and generally overcame the inhibitory effect of essential oils after 24 h of exposure. Among the fatty acids, lauric and palmitoleic acids exhibited the greatest inhibitory effect with minimum inhibitory concentrations of 250 to 500 micrograms/ml, while myristic, palmitic, stearic and oleic acids were completely ineffective. For essential oils, clove, cinnamon, pimento, and rosemary were found to be the most active. The 1/100 dilution of those oils inhibited at least five of the six tested organisms. A relationship was found between the inhibitory effect of essential oils and the presence of eugenol and cinnamaldehyde.

Combined effect of ascorbic acid and gamma irradiation on microbial and sensorial characteristics of beef patties during refrigerated storage.

The present study was undertaken to evaluate the effect of ascorbic acid concentrations (0.03 to 0.5%) and irradiation doses (0.5 to 4 kGy) on microbial growth, color coordinates (L, a, and b), and sensory characteristics (taste and odor) of beef patties during storage at 4 +/- 1 degrees C. Ascorbic acid was also compared to citric acid at a similar pH value in order to differentiate the effects of ascorbic acid from those of pH reduction. Results showed significant reduction (p< or = 0.05) of aerobic plate counts (APCs) and total coliforms, and a significant interaction (p< or = 0.05) between ascorbic acid and irradiation dose was observed. The irradiation treatment had detrimental effects on redness, yellowness, and hue angle values of meat. However, incorporation of ascorbic acid into the meat before irradiation resulted in significant (p< or = 0.05) stabilization of color parameters. The color improvement obtained with ascorbic acid was not related to the pH reduction. Also, no significant detrimental effect on taste or odor was found in irradiated samples containing ascorbic acid.