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Posterior Reversible Encephalopathy Syndrome (PRES) is a radio-clinical entity associating reversible damage of the central nervous system and typical brain imaging. The clinical context is often suggestive with, in half of cases, the use of vasoactive substances (cannabis, antidepressants, nasal decongestants) and/or postpartum. The etiologies are dominated by hypertensive encephalopathy, preeclampsia, eclampsia, immunosuppressive therapies, and systemic diseases. We report a case of posterior encephalopathy syndrome occurring in a young female without hypertension. It was about a 40-year-old female without hypertension underlying condition, received at the emergency department for headaches and generalized tonic-clonic seizures. The physical examination was unremarkable, and her blood pressure was 130/70 mm Hg. CT scan revealed bilateral white matter hypodensity in the posterior occipital regions and a right frontal subarachnoid hemorrhage. There was no aneurysmal malformation of the polygon of Willis and no cerebral thrombophlebitis. Brain MRI showed T2 and FLAIR hypersignal areas in the occipital and frontal cortico-subcortical regions, with no diffusion signal abnormalities or contrast enhancement, and a right frontal subarachnoid hemorrhagic lesion with no other impairment. The diagnosis of reversible posterior encephalopathy syndrome was made up, and the outcome was favorable under treatment. Posterior reversible encephalopathy syndrome is an uncommon but probably underdiagnosed condition. Hypertensive encephalopathy is the most common etiology. However, there would be cases of PRES without hypertension as shown in this observation.
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Nasopharyngeal fibroma (NF) is a rare nasopharyngeal tumor of a benign histological nature but with local aggressiveness. It is a hypervascular tumor and the main feeding artery comes from the internal maxillary artery. Surgery is the treatment of choice for this tumor but carries a significant risk of bleeding from surgical treatment. Thus, embolization carried out preoperatively effectively reduces intraoperative bleeding and thereby allows complete resection for large tumors.
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OBJECTIVES: The World Mental Health Qatar (WMHQ) study, the first national general population mental health survey in Qatar, was conducted as part of the World Health Organization (WHO) World Mental Health (WMH) Survey Initiative. It was one of the few WMH survey conducted during the COVID-19 pandemic. This paper presents the methodological advances and challenges encountered while conducting the survey by telephone during the pandemic. METHODS: Disproportionate stratified sampling using a national-level cellular telephone frame selected a representative sample of Arabic-speaking adults. Participants were initially contacted via Short Message Service text, followed by telephone interviews. WMH training materials supported a comprehensive training program, and data quality was ensured through a quality control indicator system and extensive monitoring. RESULTS: Over 234 days, 5195 interviews in Arabic were completed, averaging 77 min each. In line with Qatar's population, the majority of participants were non-Qatari residents living in Qatar (72.2%). CONCLUSIONS: A distributed remote Computer Assisted Telephone Interviewing system facilitated centralized quality monitoring and data security. However, the pandemic intensified challenges such as remote management of interviewer productivity, low response rates, and rising survey costs. The findings will inform Qatar's mental health policymakers, and the strategies used to address these challenges offer valuable insights for researchers worldwide.
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COVID-19 , Inquéritos Epidemiológicos , Humanos , Catar/epidemiologia , Adulto , Masculino , Feminino , COVID-19/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem , Controle de Qualidade , Saúde Mental , Adolescente , Idoso , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapiaRESUMO
OBJECTIVES: We investigated the feasibility of replacing face-to-face with telephone interviews conducted as part of the World Mental Health Qatar (WMHQ) survey and discuss the main methodological changes across the two pilots that were subsequently implemented in the full-scale WMHQ telephone survey. METHODS: We assessed the net mode effect by comparing the lifetime prevalence estimates of the main mental disorder classes (mood and anxiety disorders) and a number of disorders across the two survey pilots conducted prior to and post-pandemic. RESULTS: The main differences in terms of methodology for both pilots stemmed from differences in the survey mode, including questionnaire length, study recruitment method, and fielding team size and structure. These factors influenced response rates and costs. However, the lifetime prevalence estimates and other key indicators of survey results did not differ across modes. CONCLUSIONS: Our findings confirm the comparability of data collected via telephone and face-to-face modes, supporting the adoption of telephone surveys for future mental health studies, particularly in the context of pandemics. They also confirm the feasibility of changing or mixing modes depending on field conditions in future psychiatric epidemiological research.
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COVID-19 , Estudos de Viabilidade , Humanos , Catar/epidemiologia , COVID-19/epidemiologia , Adulto , Masculino , Feminino , Pessoa de Meia-Idade , Inquéritos Epidemiológicos , Transtornos Mentais/epidemiologia , Adulto Jovem , Entrevistas como Assunto , Telefone , Saúde Mental , Adolescente , PrevalênciaRESUMO
The study aimed to investigate the chemical composition and antimicrobial and antioxidant activities of the essential oil from dried seeds of Xylopia aethiopica. The essential oil was obtained by hydrodistillation and analyzed by GC/FID and GC/MS. The essential oil yield was 1.35%. Forty-nine compounds were identified in the essential oil with 1,8-cineole (16.3%), ß-pinene (14.8%), trans-pinocarveol (9.1%), myrtenol (8.3%), α-pinene (5.9%), and terpinen-4-ol (5.6%) as major components. The antimicrobial activity of this essential oil was studied using disk diffusion and broth microdilution methods on four bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, and Pseudomonas aeruginosa) and one fungus (Candida albicans). The essential oil exhibited excellent activity against S. aureus, E. faecalis, and C. albicans and moderate activity against E. coli. Among all strains tested, C. albicans showed the best sensitivity with a MIC of 50 mg/mL. The antioxidant activity was examined using a DPPH-free radical scavenging assay. The essential oil of X. aethiopica showed low antioxidant activity (IC50 = 784.604 ± 0.320 mg/mL) compared to that of ascorbic acid and the reference compound (IC50 = 0.163 ± 0.003 mg/mL). The results indicate that consumption of X. aethiopica seeds can reduce the virulence of food-borne pathogens and their resistance to antibiotics.
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Urban malaria has become a challenge for most African countries due to urbanization, with increasing population sizes, overcrowding, and movement into cities from rural localities. The rapid expansion of cities with inappropriate water drainage systems, abundance of water storage habitats, coupled with recurrent flooding represents a concern for water-associated vector borne diseases, including malaria. This situation could threaten progress made towards malaria elimination in sub-Saharan countries, including Senegal, where urban malaria has presented as a threat to national elimination gains. To assess drivers of urban malaria in Senegal, a 5-month study was carried out from August to December 2019 in three major urban areas and hotspots for malaria incidence (Diourbel, Touba, and Kaolack) including the rainy season (August-October) and partly dry season (November-December). The aim was to characterize malaria vector larval habitats, vector dynamics across both seasons, and to identify the primary eco- environmental entomological factors contributing to observed urban malaria transmission. A total of 145 Anopheles larval habitats were found, mapped, and monitored monthly. This included 32 in Diourbel, 83 in Touba, and 30 in Kaolack. The number of larval habitats fluctuated seasonally, with a decrease during the dry season. In Diourbel, 22 of the 32 monitored larval habitats (68.75%) were dried out by December and considered temporary, while the remaining 10 (31.25%) were classified as permanent. In the city of Touba 28 (33.73%) were temporary habitats, and of those 57%, 71% and 100% dried up respectively by October, November, and December. However, 55 (66.27%) habitats were permanent water storage basins which persisted throughout the study. In Kaolack, 12 (40%) permanent and 18 (60%) temporary Anopheles larval habitats were found and monitored during the study. Three malaria vectors (An. arabiensis, An. pharoensis and An. funestus s.l.) were found across the surveyed larval habitats, and An. arabiensis was found in all three cities and was the only species found in the city of Diourbel, while An. arabiensis, An. pharoensis, and An. funestus s.l. were detected in the cities of Touba and Kaolack. The spatiotemporal observations of immature malaria vectors in Senegal provide evidence of permanent productive malaria vector larval habitats year-round in three major urban centers in Senegal, which may be driving high urban malaria incidence. This study aimed to assess the presence and type of anopheline larvae habitats in urban areas. The preliminary data will better inform subsequent detailed additional studies and seasonally appropriate, cost-effective, and sustainable larval source management (LSM) strategies by the National Malaria Control Programme (NMCP).
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Anopheles , Cidades , Ecossistema , Larva , Malária , Mosquitos Vetores , Estações do Ano , Animais , Anopheles/parasitologia , Senegal/epidemiologia , Malária/epidemiologia , Malária/transmissão , Mosquitos Vetores/parasitologia , Incidência , HumanosRESUMO
Objectives Representing approximately 22% of cervical spine injuries, upper cervical spine injuries are becoming more frequent with the increase in road traffic accidents. The purpose of our study is to evaluate the results of our surgical series and to compare them with the literature. Materials and Methods In this monocentric retrospective study of over three years (June 2019-May 2022), all the patients with traumatic injuries of the upper cervical spine with a surgical treatment and a minimum of 12 months follow-up were included. Results The average age was 32.7 years, with a predominance of young patients. The predominant cause of injury was road traffic accident (86.3%). The clinical symptoms were cervical pain, associated with a motor deficit in two cases. Jefferson fracture associated with odontoid fracture was the most frequent injury (36.3%), followed by Hangman fracture (22.7%). Ten patients were treated with the Harms technique, four with occipitocervical C0-C2-C3 fixation, two with anterior screw insertion of the odontoid, and six with anterior C2-C3 arthrodesis. The average duration of follow-up was 12.2 months. The outcome was favorable in 21 cases and average in 1 case. Surgical morbidity and mortality were inexistent. Conclusion This short series shows the effectiveness of surgical treatment in the managing traumatic injuries of the upper cervical spine and in the regression of the pain with a low risk of surgical morbidity and mortality.
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OBJECTIVE: The objective of this work was to study the place of ultrasound in the positive diagnosis, etiology and choice of the therapeutic modality of acute intestinal intussusception. MATERIAL AND METHODS: This was a retrospective, descriptive, cross-sectional, multicenterstudy, carried out over a period of 18 months (January 1, 2016 to June 30, 2017) on 45 patient files collected in the radiologydepartments (Aristide Le Dantec and Albert Royer). Were included all patients aged less than 14 years, admitted with acute abdominal pain, whose diagnosis of IIA was retained on ultrasound. Pneumatic disinvagination was performed in patients without signs of severity. We studied the time of management, the ultrasound aspects of the invagination puddles, the therapeutic choice but also the radiosurgical concordance and the factors of failure of the pneumatic enema. Statistical analysis was done by SPSS version 21.0 software. RESULTS: Ultrasound was used to make the diagnosis of IIA in 43 cases (95.5%). The sonographic characteristics were as follows: 27.9% of the IIA were located in the right hypochondrium, 19 cases were ileo-caecal, 10 (22.2%) ileo-caeco-colic, 9 (20%) ileo-colic, 4 (8.9%) colo-colic and one (2.2%) gregelic; 44 cases were idiopathic and one case was a Meckel's diverticulum The management time was less than 48 hours in 34% of cases and 66% more than 48 hours. Pneumatic reduction was performed in 18 cases (40%), with success in 14 cases (77.8%) and one case of pneumoperitoneum complication. Surgery was performed in 31 cases (68.8%). The sensitivity and specificity of ultrasound in the diagnosis of signs of severity were 77.7% and 78.9%. Good agreement was observed between the results of the Doppler ultrasound and the intraoperative findings. Ultrasound parameters associated with failed pneumatic deinvagination were: outer cylinder thickness ≥10 mm, adenopathy at the level of the small-axis bladder ≥10 mm, effusion in the bladder, and hypovascularization of the bladder head. Hypovascularization of the boudin head was the only factor independently associated with failure of pneumatic disinvagination. CONCLUSION: Ultrasound is a powerful imaging modality in the positive diagnosis, etiology, severity and therapeutic choice of IIA.
OBJECTIF: L'objectif de ce travail était d'étudier la place de l'échographie dans le diagnostic positif, étiologique et le choix de la modalité thérapeutique des invaginations intestinales aigues. MATÉRIEL ET MÉTHODES: Il s'agissait d'une étude rétrospective, descriptive, transversale, multicentrique, réalisée sur une période de 18 mois (01 Janvier 2016 au 30 Juin 2017) portant sur 45 dossiers de patients colligés dans les services de radiologie (Aristide Le Dantec et Albert Royer). Ont été inclus tous les patients âgés de moins de 14 ans, admis dans un tableau de douleur abdominale aigue, dont le diagnostic d'IIA était retenu à l'échographie. Une désinvagination pneumatique a été réalisée chez les patients sans signe de gravité.Nous avons étudié le délai de prise en charge, les aspects échographiques des boudins d'invagination, le choix thérapeutique mais aussi la concordance radio-chirurgicale et les facteurs d'échec du Lavement pneumatique. L'analyse statistique a été faite par le logiciel SPSS version 21.0. RÉSULTATS: L'échographie a permis de faire le diagnostic d'IIA dans 43 cas (95,5%). Les caractéristiques échographiques étaient les suivantes : 27,9% des IIA siégeaient au niveau de l'hypochondre droit, 19 cas de forme iléo-caecales, 10(22,2%) cas iléo-caeco-colique, 9(20%) casiléo-colique, 4(8,9%)cascolo-colique et un cas (2,2%) grélo-grélique; 44 cas idiopathiques et un cas de diverticule de Meckel. Le delais de prise en charge était inférieur à 48heures dans 34 % des cas et 66% supérieur à 48heures. Une réduction pneumatique a été réalisée dans 18 cas (40%), avec succès dans 14 cas (77,8%) et un cas de complication à type de pneumopéritoine. Une chirurgie était réalisée dans 31 cas (68,8%). La sensibilité et la spécificité de l'échographie dans le diagnostic des signes de gravité étaient de 77,7% et 78,9%. Une bonne concordance étaitobservée entre les résultats de l'écho-Doppler et les constatations peropératoires. Les paramètreséchographiquesassociés à un échec de la désinvagination pneumatique étaient : une épaisseur du cylindre externe ≥10 mm, des adénopathies au niveau du boudin de petit axe ≥10 mm, un épanchement dans le boudin et une hypovascularisation de la tête du boudin. L'hypovascularisation de la tête du boudin était le seul facteur indépendamment associe à l'échec de la désinvagination pneumatique. CONCLUSION: L'échographie est une modalité performante d'imagerie dans le diagnostic positif, étiologique, de gravité et dans le choix thérapeutique des IIA.