On-chip conductometric detection of short DNA sequences via electro-hydrodynamic aggregation.

Fluorescence measurement is the main technology for post-amplification DNA detection in automated systems. Direct electrical reading of DNA concentration in solution could be an interesting alternative to go toward more miniaturized or less expensive devices, in particular in the pathogen detection field. Here we present the detection of short bacterial biomarkers with a direct impedancemetric measurement, within solutions of amplified and elongated DNA sequences in a microchannel. This technology relies on the electrohydrodynamic instability occurring in solutions of long charged macromolecules in a strong electric field. This instability specifically induces the aggregation of long DNAs and triggers conductivity variations that can be monitored by on-contact conductometry. An innovative isothermal amplification and elongation strategy was developed, combining SDA and HRCA reactions, in order to yield long DNAs suitable to be detected by the above principle, from a dilute initial DNA target. In contrast with previous label-free detection methods, this new strategy is very robust to matrix effects, thanks to the unique molecular weight dependence of the instability, coupled with this specific DNA amplification strategy. We demonstrate the detection of a 1 pM gene sequence specific to Staphylococcus aureus, in a portable system.

[Role Of Imaging In The Management Of A Case Of Intrauterine Device Migration]. / Role De L'imagerie Dans La Prise En Charge D'un Cas De Migration De Dispositif Intra-Uterin.

We report a case of intrauterine device (IUD) migration in order to describe the contribution of imaging in its diagnosis. It was a 35-year-old woman received on 06/01/2018 for pelvic ultrasound for pelvic pain. Ultrasound examination revealed a hyperechoic right para-uterine tubular image. A hysterosalpingography revealed an IUD in the pelvis in extra-urine position. Surgical extraction was done without complications. Intrauterine device migration is rare in our context. The radiological means make it possible to specify its topography.

Nous rapportons un cas de migration de dispositif intra-utérin (DIU) dans le but de décrire l'apport de l'imagerie dans son diagnostic. Il s'agissait d'une dame de 35 ans reçue le 01/06/2018 pour une échographie pelvienne dans le bilan d'une douleur pelvienne. L'exploration échographique a objectivé une image hyperéchogène tubulaire para-utérine droite. Une hystérosalpingographie avait objectivé un DIU dans le bassin en position extra-urine. Uneextraction chirurgicale a été faite avec des suites simples. La migration de dispositif intra-utérin est rare dans notre contexte. Les moyens radiologiques permettent de préciser sa topographie.

[Compliance's assessment of ultrasound and x-ray requests at Mopti's Sominé Dolo hospital]. / Evaluation de la conformite des demandes d'echographie et de radiographie a l'hopital Somine Dolo de Mopti.

OBJECTIVE: To assess the compliance of requests for ultrasound and radiography examinations at Mopti's hospital. MATERIALS AND METHODS: This was a cross-sectional study from January 2018 to June 2018. The variables analyzed were the different compliance criteria grouped into administrative, clinical and minor.The data analysis was done with SPSS version 20 and Excel 2013 software. RESULTS: Out of 2000 requests, radiography represented 61.05% compared to 38.95% of ultrasound cases. The administrative criteria were completed in more than 95% of the cases. The purpose of the review was absent in 95% of the requests. The non-compliance rate for the requests was 95.65%. The requests of general practitioners, specialists and medical assistants were respectively non-compliant with 93.62%; 95.68% and 100%. CONCLUSION: At the end of this study, we observed an insufficiency in the quality of prescriptions for requests for medical imaging examinations with a high rate of non-compliance. This could lead to examination practice not suited to the clinical situation, interpretation errors, complications for the patient and high and unnecessary economic cost.

OBJECTIF: Evaluer la conformité des demandes d'examens d'échographie et de radiographie à l'hôpital de Mopti. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude transversale de Janvier 2018 à juin 2018. Les variables analysées étaient les différents critères de conformité regroupés en critères administratifs, cliniques et mineurs.L'analyse des données a été faite avec les logiciels SPSS version 20 et Excel 2013. RÉSULTATS: Sur 2000 demandes, la radiographie représentait 61,05 % contre 38,95 % de cas d'échographie.Les critères administratifs étaient renseignés dans plus de 95% des cas. La finalité de l'examen était absente dans 95% des demandes. Le taux de non-conformité des demandes était 95,65 %. Les demandes des médecins généralistes, des spécialistes et des assistants médicaux étaient respectivement non conformes avec 93,62%; 95,68% et 100%. CONCLUSION: Au terme de cette étude nous avons observé une insuffisance dans la qualité des prescriptions des demandes des examens d'imagerie médicale avec un taux de non-conformité élevé. Ceci pourrait être à l'origine d'une pratique d'examen non adaptée à la situation clinique, des erreurs d'interprétation, des complications pour le patient et d'un coût économique élevé et inutile.

[Should the administration of anticoagulants be altered for oral surgery: a study of 32 cases]. / Faut-il interrompre l'administration d'anticoagulants pour un Acte de Chirurgie Buccale: a propos d'une étude de 32 cas.

INTRODUCTION: The study is transversal and descriptive. It take place in the odontology department in a public hospital in Dakar (Senegal), during 09 month (January-September 2005). The objective of this work was to determine the TP-INR value making possible to carry out an act of oral surgery without haemorrhagic risk. (INR = International Normalized Ratio). MATERIAL AND METHOD: It concerned 32 patients referred to the Odontology service by the Cardiology They presented a cardiovascular pathology having required an anticoagulant therapy, and also need an act of oral surgery. We exploited the following parameters: identification of the patient, oral state, types of oral surgery, types of cardiopathy, AVK posology, value of TP-INR, haemostatics means. RESULTS: 81.25% of the patients were women (26), with a sex ratio of 0.23. The mean age was 53ans, with 21 and 84 years like the extremes. 56.25% of our patients had undergone a single extraction, 25% had beneficed multiple extractions, and 18.75% had profited from a scaling-curetting. The average value of the TP-INR was 2.22 with extremes between 2 and 2.84. CONCLUSION: In favour of the haemostat means, no haemorrhagic complication post operational was revealed. It is allowed that the risk of thromboembolic accident by stopping the treatment is much more prejudicial than the hemorrhagic risk for the patient.

qSR: a quantitative super-resolution analysis tool reveals the cell-cycle dependent organization of RNA Polymerase I in live human cells.

We present qSR, an analytical tool for the quantitative analysis of single molecule based super-resolution data. The software is created as an open-source platform integrating multiple algorithms for rigorous spatial and temporal characterizations of protein clusters in super-resolution data of living cells. First, we illustrate qSR using a sample live cell data of RNA Polymerase II (Pol II) as an example of highly dynamic sub-diffractive clusters. Then we utilize qSR to investigate the organization and dynamics of endogenous RNA Polymerase I (Pol I) in live human cells, throughout the cell cycle. Our analysis reveals a previously uncharacterized transient clustering of Pol I. Both stable and transient populations of Pol I clusters co-exist in individual living cells, and their relative fraction vary during cell cycle, in a manner correlating with global gene expression. Thus, qSR serves to facilitate the study of protein organization and dynamics with very high spatial and temporal resolutions directly in live cell.

[Frequency, risk factors and prognostic value of anemia associated with HIV/AIDS in the adult in Mali]. / Fréquence, facteurs de risque et valeur pronostique de l'anémie associée au VIH/SIDA chez l'adulte au Mali.

Anaemia is a common complication of the HIV infection. To understand the mechanism of HIV associated anaemia and to suggest a consequent therapeutic approach in adults in Mali, we undertook a prospective case/control study in two services of reference with essentially adults recruitment in Bamako. We studied the frequency, the risk factors and the prognosis value of this complication in 133 patients with HIV infection matched to 133 others non HIV infected. The average age of our patients was 36.08 +/- 8.80 years (age range: 19 to 66 years). The frequency of anaemia was significantly higher in patients with HIV infection compared to the controls (78.9% vs. 51.9%; OR = 2.46; 95% CI [1.56-3.92]). Anaemia was more frequent in women than in men (p = 0.00003). A significant association between anaemia and thrombopenia or lymphopenia was observed only in patients with HIV infection. The severity of anemia was positively associated with the HIV2 infection and the progression of the HIV disease. Mortality was more frequently associated to the anaemia (p < 10(-5)) in patients infected by HIV. These findings suggest that bone marrow depression leading to a decreased red blood cells production is the main mechanism of HIV associated anaemia in adult in Mali. Therefore, without evidence of a best cost-effectiveness ratio of a human recombinant erythropoietin treatment in the context of countries with a low income, the therapy of this haematological complication must be an emergency focusing on red blood cells transfusions.

[Frequency of skin consultations in the activities of internal medicine service at national hospital of Point G in bamako]. / Fréquence des consultations dermatologiques dans les activités du service de médecine interne de l'hôpital national du point g a bamako.

AIM: To investigate epidemiologic clinical, paraclinical and therapeutic appearances of skin diseases identified in the Internal Medicine Department. PATIENTS AND METHODS: This was a retrospective descriptive study on records collected from January 1st, 1997 to September 30th, 2000. Have been selected records of patients who consulted and / or hospitalized for a dermatological reason. RESULTS: The average age was 36.42 ± 16.52 years. Female sex predominated with 55.06% for a ratio of 0.81. Dermatological consultation represented 30.41% of the activities of Internal Medicine. The pruritic dermatoses predominated (60.12%) among those infectious etiologies (45.46%), inflammatory dermatoses reaction (26.49%), dermatitis tumor (10.39%), autoimmune dermatoses (6.56%) and vasculitis (1.19%). Prurigo, herpes zoster and Kaposi's sarcoma with frequencies of 22.41%, 16.38% and 12.93% were most often associated with HIV / AIDS. The therapy consisted of prescription antiseptic, topical corticosteroids of compounding, antibiotic and antifungal orally. CONCLUSION: Skin conditions are often common in internal medicine, infectious causes and especially reaction. Kaposi's sarcoma because of its association with HIV is common skin tumor identified. The usual drugs remain effective.

BUT: Étudier les aspects épidémioclinique, paraclinique et thérapeutique des affections cutanées recensées dans le service de Médecine Interne. PATIENTS ET MÉTHODE: Il s'agissait d'une étude rétrospective descriptive portant sur les dossiers colligés du 1er Janvier 1997 au 30 Septembre 2000. Ont été retenus les dossiers des patients ayant consulté et/ou hospitalisé pour un motif dermatologique. RÉSULTATS: La moyenne d'âge était de 36,42±16,52 ans. Le sexe féminin prédominait avec 55,06% pour un ratio de 0,81. La consultation dermatologique représentait 30,41% des activités du service de Médecine Interne. Les dermatoses prurigineuses ont prédominé (60,12%) parmi celles de cause infectieuse (45,46%), les dermatoses réactionnelles inflammatoires (26,49%); les dermatoses tumorales (10,39%); les dermatoses auto-immunes (6,56%) et les vascularites (1,19%). Le prurigo, le zona et la maladie de Kaposi avec des fréquences respectives de 22,41%; 16,38% et 12,93% étaient le plus souvent associés au VIH/SIDA. La thérapeutique a consisté à la prescription d'antiseptique, de dermocorticoïdes, de préparation magistrale, d'antibiotique et d'antimycosique per os. CONCLUSION: Les affections dermatologiques sont souvent fréquentes en Médecine Interne, de causes surtout infectieuse et réactionnelle. La maladie de Kaposi en raison de son association avec le VIH, est la fréquente tumeur cutanée recensée. Les médicaments usuels demeurent efficaces.

Dépistage des affections oculaires chez des travailleurs d'une entreprise de télécommunication, Lomé, Togo / NA

Les yeux constituent un organe important dans la mise en oeuvre des activités professionnelles et extraprofessionnelles. Dans le cadre d'une entreprise de télécommunication, il a été constaté une augmentation croissante des problèmes oculaires d'années en années.L'objectif de l'étudeétaitde décrire l'épidémiologiedes affections oculaires en fonction de l'exposition à l'écranchez lestravailleurs d'une entreprise de Télécommunication au Togo. Il s'agissait d'une étude transversale. Une analyse descriptive a été faite en fonction de l'exposition au travail sur écran.Sur les 766 participants inclus, 599 étaient des hommes (78,20%).La prévalence des affections oculaires était très élevée indépendamment de l'exposition au travail sur écran en dehors des conjonctivites.Les principales affections oculaires étaient représentées par: une proportion significativement faible de cas d'amétropie (81% vs 97%) et de cataracte (6% vs 13%) chez les travailleurs exposés par rapport à ceux non exposés à l'exception des conjonctivites (32% vs 23%) qui étaient significativement plus fréquentes chez les exposés au travail sur écran de visualisation que les non exposés. L'âge influençait significativement la survenue de ces pathologies à l'exception des conjonctivites.Les facteurs tels que l'âge et les antécédents médicaux et professionnels des travailleurs devront être pris en compte dans le suivi de l'état oculaire des travailleurs.

The eyes are an important organ in the performance of professional and extra-professional activities. In the context of a telecommunications company, eye problems increase from year to year. The objective of this study was to describe the epidemiology of eye diseases as a function of screen exposure among workers in a telecommunications company in Togo. This was a cross- sectional study. A descriptive analysis was done based on the exposure to screen-based work. Of the 766 participants included, 599 were male (78.20%). The prevalence of eye diseases was very high regardless of exposure to screen-based work outside conjunctivitis. The main ocular disorders were represented by: a significantly low proportion of cases of ametropia (81% vs 97%) and cataracts (6% vs 13%) in exposed workers compared to unexposed workers, with the exception of conjunctivitis (32% vs 23%) which were significantly more frequent in occupational exposures on visual display screens than unexposed workers. Age significantly influenced the occurrence of these pathologies with the exception of conjunctivitis. Factors such as the age and medical and occupational history of workers should be taken into account when monitoring the ocular status of workers.

Statut de travailleur tuberculeux et environnement professionnel, Cotonou, Bénin / NA

Le partage du statut de tuberculose (TB) peut être pour le patient une source de conflit en milieu professionnel en raison de la stigmatisation liée à la maladie. L'objectif de la présente étude était d'évaluer les raisons et les réactions de partage ou non du statut de patient TB en milieu professionnel.Il s'agissait d'une étude transversale descriptive ayant inclus lestravailleurs TB du Centre National Hospitalier de Pneumo-Phtisiologie de Cotonou. Sur les 107 travailleurs inclus, 50% provenaient des petites entreprises privées et 30% du secteur informel. Parmi ceux qui avaient des supérieurs (43/107) ou des collègues (68/107) de service, respectivement 65,1% et 41,2% n'ont pas informé leur supérieur hiérarchique ou au moins un collègue. Les raisons évoquées étaient : crainte d'une perte de l'emploi (40%), peur du rejet (68%).La majorité de ceux qui avait partagé leur statut avaiteu en retour une réaction d'acceptation de la part de leur employeur (86,7 %) et collègues (85%).

Sharing tuberculosis status can be a source of conflict for the patient in the workplace due to the stigma associated with the disease. The objective of this study was to assess the reasons and reactions for and against sharing TB patient status in the workplace. This was a descriptive cross-sectional study that included tuberculosis workers at the National Tuberculosis Center at Cotonou. Of the 107 workers included, 50% came from small private companies and 30% from the informal sector. Of those who had supervisors (43/107) or colleagues (68/107) on duty, 65.1% and 41.2% respectively did not inform their supervisor or at least one colleague. The reasons given were: fear of job loss (40%), fear of rejection (68%). The majority of those who had shared their status had in turn received an acceptance reaction from their employer (86.7%) and colleagues (85%).

[Cerebral toxoplasmosis during AIDS in the infectious diseases department of Point-G Teaching Hospital, Bamako, Mali]. / Toxoplasmose Cerebrale Au Cours Du Sida Dans Le Service Des Maladies Infectieuses Du CHU Du Point-G, Bamako-Mali.

Cerebral toxoplasmosis is common opportunistic infections of central nervous system in AIDS. It occurs most often in case of severe immunosuppression. The aim of this study is to investigate the general characteristics of cerebral toxoplasmosis during HIV infection and AIDS in hospital area in Bamako. It is a retrospective study of 5 years (form January 2001 to December 2005), conducted in the infectious diseases department of Point G Teaching Hospital of Bamako. It concerned all patients infected with HIV, hospitalized for cerebral toxoplasmosis. The diagnosis of cerebral toxoplasmosis was based on clinical, C T and therapeutic arguments. A total of 745 patients investigated, 26 met cerebral toxoplasmosis diagnostic criteria (14 men and 12 women). The rate of cerebral toxoplasmosis in the study population was 3.5%. The average age was 38.1 years (18-58 years). Focused neurological deficit (73.07%), intracranial hypertension signs (69.20%), meningeal syndrome (15.40%), seizures (57.69%) and consciousness disorders (30.80%) were the clinical characteristics. Hypodensity with or without peripheral enhancement images (93.75%) were found on CT. The average rate of CD4 T cells was 98.7cells/mm3 (5-473 cells/mm3). Oropharyngeal candidiasis in 61.53% of cases, intestinal cryptosporidiosis (11.53%), herpes zoster (3.84%) and Pott's disease (3.84%) were the opportunistic infections associated. Cotrimoxazole was used in 88.46% of patients and 3 patients (11.54%) received the standard treatment (Sulfadiazine-Pyrimethamine). Antitoxoplasmic treatment led to a clinical improvement in 84.61% and 4 deaths (15.39%). were recorded. The technical platform for etiological diagnosis of toxoplasmosis is not available at the Point-G Teaching Hospital, so in case of encephalitis signs in a HIV positive patient, CT should be urgently perform and a treatment trial must begin without delay.

[Cutaneous drug eruption at hospital in Bamako]. / Toxidermie Medicamenteuse En Milieu Hospitalier A Bamako.

INTRODUCTION: The incidences of cutaneous drug eruption constitute a real public health problem. OBJECTIVE: The aim of this study was to describe the cutaneous drug eruption in Gabriel Touré Hospital in Bamako. MATERIAL AND METHOD: This is a prospective longitudinal study from 1 July 2005 to August 31, 2006. The study included patients with a lesion cutaneous Contemporary taking medication, without other cause and consent. RESULTS: We included 61 cases of toxdermies. The mean age was 28 ± 14.8 years with extremes of 18 and 77 years. The sex ratio was 2.4 for women. Self-medication was most often found in 51% of cases. The fixed drug eruption (EPF) with 26 cases (30.6%); acne with 23 cases (27%), erythema multiforme with 14 cases (16.5%) are the predominant manifestations toxidermy. The causative drugs are molecules with 12.6% with analgesics, NSAIDs with 12.6%, 13.6% with ARVs; sulfonamides with 9.5% with 7.4% beta-lactam; anticonvulsants with 5.2%. The therapeutic management was simple for minor forms. Severe forms have been hospitalized and often the help of intensive care and ophthalmology. Mortality was 2.3%. CONCLUSION: The toxidermy exist in Mali with a frequency more and more increasing. We recommend the systematic toxidermy consultations especially among HIV patients in Mali.

[AIDS related Kaposi's disease in Hospital area in Bamako]. / La Maladie de Kaposi au cours du VIH/Sida en milieu hospitalier de Bamako.

The goal of this prospective work were to describe the clinical, therapeutic and evolutionary aspects of Kaposi's disease occurring during AIDS in the infectious diseases service from October 1, 2004 to September 30, 2005. The diagnosis of the infection by the HIV was based on the positivity of serology with 2 fast tests. That of the Kaposi's disease was based on the clinical aspect and /or histological of the lesions. On these 2189 patients, 37 presented the Kaposi's disease that means a prevalence of 1.6%. They were 17 men and 20 women average age 39.5 years and heterosexuals in 97.30 % of the cases. Kaposi's disease limited on the skin and mucous were most represented within (48.65 %), followed by the skin limited (43.24 %) and mucous localization (8.11%). Papulo-nodulare feature was the major clinical founded to the physical examination in 54.05 %. The rate of average CD4 was 76 cellules/mm3 with the extreme one going from 1 to 512 cellules/mm3. It was favorable at 14 (43.75%) of the 32 patients having profited from antiretroviral treatment. The Kaposi's disease during the AIDS is relatively frequent with the service of the infectious diseases and the prognosis remains severe. However the antiretroviral therapy can improve the prognosis of the skin limited forms.

[Association of urinary tract infections and HIV infection in an internal medicine ward of Hospital of Point G-Bamako-Mali]. / L'association infection urinairie st infection VIH a dans le service de medicine interne de l'Hopital du Point G-Bamako-Mali.

We gathered 14 clinical observations of urinary track infections in AIDS patients in Internal Medicine wards from August 1, 1998 to July 31, 1999. Urinary track infection and HIV were both present in 1.75% of 797 hospitalized patients. The specific prevalence was 14.43% among AIDS patients. The sex ratio (female/male) was 1.33. The mean age of patients was 37.2 years with ranges between 25 years and 59 years. Urinary symptoms were discret. Urinary tract infection was primarily evidenced by urine leucocytes > 10(4) organism/ml and a bacteriuria > 10(5) colony-forming units/ml. The main pathogenswere Escherichia coli (42.85%), Klebsiella pneumoniae (28.57%), Colibacilles app. (21.42%) and Enterobacter cloacae (7.14%). All isolated germs were sensible to the gentamicin, to the amikacin, to the nalidixic acid, to the cefoxitine, to the ceftazidime to the cefotaxime and the ciprofloxacin. Cephalosporin of 3rd generation, aminoglycosides, and fluoroquinolone can be used like treatment of first line in urinary tract infection suspicion case in Bamako. Our patients were highly immunosuppressed with the majority of them being in class IV C of CDC of Atlanta (90%) and CD4 count constantly bellow 200 cells/mm3. The main opportunistic affections were non bacilar bacterial pneumopathies (28.57%), oesophagal mycosis (71.42%), the association of cerebral toxoplasmosis and pulmonary tuberculosis (35.71%). All urinary infections were cured by mean of 5 days of treatment. Very few recidivism was found (1 case).

[The diabetic hand]. / Atteinte de la main chez le diabetique.

The frequent localization of the infection to the hand to ours diabetic patients oppositely to the classic description of diabetic foot leds us to initiate this work, which had the objectif to determine the prevalency and to describe the "diabetic hand" to our patients. For that we have conducted a descriptive retrospective and prospective study in the internal Medecine Service of the National Hospital of Point G (NHPG) and in Traumato Orthopaepics Service of Gabriel Touré Hospital (G.T.H.) in Bamako. In 341 diabetic examined patients 158 infections of soft areas have been listed (46.33%) with a localization on the foot in 87 among them (25.51%) and the hand in 55 (16.13%). The female sex has been the most affected with an average of 52 years old and recent discovered diabetes. The diabetes was of type I in 54.54% of cases and of type II in 45.46%. The reaching of hand was following upon a traumatism (7.28%), a burn (3.63%), an ingrown mail (3.63%); but in 85.46% of cases any front door hasn't been found. The type of damage observed has been the abscess (49.09%), the whitlow (25.46%), the gangrene (21.82%) and the burn (3.63%). We have noticed an ostect in 41.81% of cases. In bacteriologic field, the staphylocoque was the prevailing germ in relating to the negative gram (25%). The curring has required an amputation in almost a third of patients (30.9%) the healing has been gained in 76.3% of cases with sometimes some fonctional important after effects. On death has been noticed in 9.09% of cases.

[Not Available].

Sexual ambiguities are due to varied congenital or hormonal causes. A retrospective study carried out from January 1995 to December 2000 and followed by a prospective study from January 2001 to September 2002 sought to describe the clinical aspects of sexual ambiguities in Internal Medicine in a tertiary hospital Mali. Among 12 patients out of 2223 consultants identified (0.54 percent), 10 of them were phenotypically feminine and 2 phenotypically masculine. The average age of the patients was 14.3+- 8.9 years. Clinically, 3 out of the 10 phenotypically feminine patients presented an anomaly of the external genital organs; 5 out of the 10 had low axillary and pubic hair growth; 4 out of the 10 had delayed puberty; 6 out of the 10 had primary amenorrhoea; 7 out of 10 had hypoplasia of the mammary glands; and3 out of 10 had an inguinal mass. For the the 2 phenotypically masculine patients, one had a bilateral gynecomastia, a macroskelia of 2m04, a low axillary and pubic hair growth and the other had an anomaly of the external genital organs.

Pulmonary tuberculosis among diabetic patients in internal medicine at Point G Hospital, Bamako - Mali.

The depression of cellular immunity among diabetic patients exposes them to tuberculosis considered as one of the major diseases of immune-depressive people. The purpose of our study was to evaluate the frequency, gravity, treatment and evolution of pulmonary tuberculosis among our patients affected with diabetes. For that purpose, two descriptive retrospective and prospective studies were undertaken from January 1982 to December 1992 in the Internal Medicine (Internal medicine) department of Hospital of Point G, the national hospital. Thus, 54 diabetics patients hospitalised out of 1 365 had tuberculosis at a frequency rate of 3,95%. The average age of our patients was 49 years + 12 and the sex ratio was 2,18 in favour of men. The infection was also more frequent in diabetes type 1 (51,9%) then in type 2 (48,1%), and concerned mainly men (68.51%) who were more than 37 years old (57.41%). Clinically, the common signs to both affections were prevalent namely asthenia: 85,2%, anorexia: 53,7%, weight loss: 66,7%, associated to cough: 81,5% and to dyspnea: 29,6%. However, for a third of the patients (22,2%), tuberculosis was discovered during a systematic check up. All the patients had a glycemia higher than 8mmol/l, with extremes up to 8mmol/l and32mmol/l, 63% of patient had a febricula. The intradermo cutaneous reaction to tuberculosis (IDR) was negative in 44,4%. The bacilloscopy during direct testing or through the liquid obtained by casing was positive in 64,82%. Tubercular lesions were localised at the top: 91,8%, with an equal attack of the two lungs. During the treatment six products were mainly used comprising Rifampicine (R) isoniazid (INH or H), Streptomycine (S), Ethambutol (E), Thiacetazone (T), and Pyrazinamide (Z). Insulin treatment was done on all patients until tuberculosis was cured. The evolution was favourable after 2 to 3 months of treatment for 48 patients (88,88%) among whom 4: (8,33%) fell sick again. Six patients out of 54 died, i.e. 11,12%.

Pulmonary tuberculosis among diabetic patients in internal medicine at point g hospital, bamako - mali.

Summary The depression of cellular immunity among diabetic patients exposes them to tuberculosis considered as one of the major diseases of immune-depressive people. The purpose of our study was to evaluate the frequency, gravity, treatment and evolution of pulmonary tuberculosis among our patients affected with diabetes. For that purpose, two descriptive retrospective and prospective studies were undertaken from January 1982 to December 1992 in the Internal Medicine (Internal medicine) department of Hospital of Point G, the national hospital. Thus, 54 diabetics patients hospitalised out of 1 365 had tuberculosis at a frequency rate of 3,95%. The average age of our patients was 49 years +/- 12 and the sex ratio was 2,18 in favour of men. The infection was also more frequent in diabetes type 1 (51,9%) then in type 2 (48,1%), and concerned mainly men (68.51%) who were more than 37 years old (57.41%). Clinically, the common signs to both affections were prevalent namely asthenia: 85,2%, anorexia: 53,7%, weight loss: 66,7%, associated to cough: 81,5% and to dyspnea: 29,6%. However, for a third of the patients (22,2%), tuberculosis was discovered during a systematic check up. All the patients had a glycemia higher than 8mmol/l, with extremes up to 8mmol/l and 32mmol/l, 63% of patient had a febricula. The intradermo cutaneous reaction to tuberculosis (IDR) was negative in 44,4%. The bacilloscopy during direct testing or through the liquid obtained by casing was positive in 64,82%. Tubercular lesions were localised at the top: 91,8%, with an equal attack of the two lungs. During the treatment six products were mainly used comprising Rifampicine (R) isoniazid (INH or H), Streptomycine (S), Ethambutol (E), Thiacetazone (T), and Pyrazinamide (Z). Insulin treatment was done on all patients until tuberculosis was cured. The evolution was favourable after 2 to 3 months of treatment for 48 patients (88,88%) among whom 4: (8,33%) fell sick again. Six patients out of 54 died, i.e. 11,12%.

Pemphigus in Mali: a study of 30 cases.

Pemphigus has been largely studied in developed countries (North America and Europe) and in Brazil. In these geographical settings, pemphigus presents two very different epidemiological and clinical patterns. Little is known about pemphigus in other regions of the world, particularly in Africa. We report here a study of 30 cases of pemphigus observed in Bamako, Mali. Our data suggest that pemphigus in this area presents a distinctive pattern. Our cases of pemphigus were diagnosed on the basis of clinical, histological and direct immunofluorescence studies. We estimated the annual incidence in the Bamako region to be 0.29 cases per 100,000 inhabitants. There was no endemic focus in Mali. The disease was observed mainly in women (24 of 30; 80%), especially those older than 40 years (mean age, 46.7 years), and in the Fulani ethnic group (10 of 30; 33%). Our study group was composed of 25 cases of pemphigus foliaceus (PF) (83%), four cases of pemphigus vulgaris and one case of pemphigus vegetans. Pustules with hypopyon were observed in 11 patients (37%). A diffuse verrucous change in the skin was noted in four cases of erythrodermic PF. In 16 patients with PF, localized verrucous lesions mimicking seborrhoeic keratoses were observed when oral corticosteroid treatment was decreased. Histopathological examination demonstrated eosinophilic spongiosis in 50% of patients. These data suggest that pemphigus in Mali differs from the two main known patterns of the disease: the North American/European one, and the Brazilian pattern, with which it shares the predominance of superficial forms but otherwise differs in many features.

Persistent chlorinated pesticides in fish and cattle fat and their implications for human serum concentrations from the Sene-Gambian region.

The concentrations of organochlorine pesticides (OCPs) in fish, shrimps, cattle fat and human serum samples from the Sene-Gambian region were measured using validated analytical methodologies. The results obtained were compared with those of other existing African studies and with data from other developing countries. In fish samples, p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) and HCB were detected with a frequency of 100%, whereas p,p'-dichlorodiphenyltrichloroethane (p,p'-DDT) was detected in eight, heptachlorepoxide in six and endosulfansulfate in five of the nine fish samples. Relatively low concentrations of OCPs were found in cattle and shrimp fat samples. p,p'-DDE and alpha-hexachlorocyclohexane (alpha-HCH) were the most frequently identified. The sum of HCHs ranged from undetected to 13.3 ng g-1 fat, the sum of DDTs from 11.1 to 199.2 ng g-1 fat and the sum of endosulfans from not detected to 49.7 ng g-1 fat in fish and shrimps. In serum samples, alpha-HCH, p,p'-DDE, o,p'-DDT and p,p'-DDT were detected in all 16 pooled serum samples, whereas endosulfansulfate, methoxychlor, mirex, heptachlorepoxide and endrin were detected in 15 samples with most of the concentrations below 10 ng mL-1. The concentrations of OCPs in human serum were given on a serum lipid and whole serum volume basis. The implications for the human diet of these OCP concentrations in serum were investigated by means of biomagnification factors related to the log Kow values of the targeted compounds. The current use of HCH mixtures was suggested to explain the unusually high alpha-HCH concentration. The distribution pattern of these OCPs in humans was also discussed and compared with that in other studies.