[Cephalic tetanus revealed by peripheral facial palsy]. / Tétanos céphalique révélé par une paralysie faciale.

INTRODUCTION: Cephalic tetanus is a rare presentation of localized tetanus (1 to 3% of localized presentations). It is a very rare cause of peripheral facial palsy. OBSERVATION: We report a case of cephalic tetanus revealed by peripheral facial palsy and trismus. DISCUSSION: Facial peripheral palsy often appears after trismus. It is very rarely the first symptom of cephalic tetanus, making the diagnosis difficult.

Electromyographyc evaluation of movements of lower limb in double pulley system equipment: comparison between gastrocnemius (caput laterale) and gluteus maximus.

It was evaluated movements of lower limb in the double pulley system equipment on ten male volunteers during contraction of gastrocnemius (caput laterale) and gluteus maximus muscles in the following movements: 1) hip extension with extended knee and erect trunk, 2) hip extension with flexed knee and erect trunk, 3) hip extension with flexed knee and erect trunk, 3) hip extension with extended knee and inclined trunk, 5) hip abduction along the midline, 7) hip abduction with extension beyond the midline, 8) adduction with hip flexion beyond the midline, 8) adduction with hip flexion beyond the midline, and 9) adduction with hip extension beyond the midline. Myoelectric signals were taken up by Lec Tec surface electrodes connected to a 6-channel Lynx electromyographic signal amplifier coupled with a computer equipped with a model CAD 10/26 analogue digital conversion board and with a specific software for signal recording and analysis. We observed weak gastrocnemius muscle activity for all movements studied. In the case of gluteus maximus, the most important potentials were observed for movement 2, while for the remaining movements the actions were of reasonable intensity. Compared to gluteus, gastrocnemius was less required for all movements.

[Cutaneous cryptococcosis mimicking basal cell carcinoma and revealing systemic involvement in acquired immunodeficiency]. / Cryptococcose cutanée mimant un carcinome basocellulaire et révélant une atteinte systémique sur immunodéficience acquise.

BACKGROUND: Cryptococcosis is a rare and a serious opportunistic infection that occurs primarily on the field of immunodeficiency. We report a case of disseminated cryptococcosis in acquired immunodeficiency syndrome revealed by unusual skin lesions. OBSERVATION: A 52-year-old patient consulted for two crusty ulcerative lesions situated on the left supraorbital and on the nasal tip that appeared 6 months ago. He also reported respiratory symptoms present since one year, with dry cough and dyspnea, chronic headache and vomiting with no alteration in visual acuity. The mycological study of the skin biopsy on both lesions isolated Cryptococcus neoformans as well as in the sputum and cerebrospinal fluid. Serology of human immunodeficiency virus infection was positive. Treatment with fluconazole, local care and antiretroviral triple therapy was implemented. DISCUSSION: Skin lesions during cryptococcosis are rare and observed in 2-10% of cases. Cutaneous symptoms were the reason for consultation in our patient. This is a rare form of cutaneous cryptococcosis leading to the discovery of both pulmonary and central nervous system locations, and to diagnosis of HIV infection.

Electromyographic validation of the double pulley equipment during movements of the lower limbs.

The double pulley equipment was tested on ten male volunteers during contraction of the semitendinosus and biceps femoris (caput longum) muscles in the following movements of the lower limbs: 1) hip extension with extended knee and erect trunk, 2) hip extension with flexed knee and erect trunk, 3) hip extension with flexed knee and erect trunk, 3) hip extension with extended knee and inclined trunk, 5) hip abduction along the midline, 7) hip abduction with extension beyond the midline, 8) adduction with hip flexion beyond the midline, 8) adduction with hip flexion beyond the midline, and 9) adduction with hip extension beyond the midline. The myoelectric signals were taken up by Lec Tec surface electrodes connected to a 6-channel Lynx electromyographic signal amplifier coupled with a computer equipped with a model CAD 10/26 analogue digital conversion board and with a specific software for signal recording and analysis. The semitendinosus and biceps femoris muscles presented the highest potentials in movements 1; 2; 7, 8 and 9, whereas the potentials in the remaining movements were negligible. The pattern of activity of the semitendinosus and the biceps femoris was similar in exercises 1, 2, 3, 4 and 8. The potentials of the semitendinosus prevailed in movements 5, 6 and 7, and the strongest potentials observed in movement 9 were those of the biceps femoris.

Electromyographic behaviour of the gastrocnemius muscle during knee extension and flexion performed on the leg press.

The gastrocnemius was analysed in 10 male volunteers during knee flexion and extension with the foot in normal, plantar flexion and dorsal flexion positions. Hewlett-Packard surface electrodes, an electromyographic signal amplifier, a computer equipped with an A/D conversion plaque (Model CAD 10/26), a software specially designed to record and analyse the signals, a horizontal leg press, and electrogoniometers were used. The gastrocnemius muscle showed strong potentials at the end of knee extension and beginning of knee flexion. The muscle presented a similar activity both in the upper and lower platforms. As to bilateral action, the right gastrocnemius presented stronger potentials on the upper platforms, whereas the potentials were bilaterally similar on the lower platforms. As for foot position, the gastrocnemius presented strong potentials when the foot was in plantar flexion. The remaining positions had no effect on the work of the muscle.

Electromyographic evaluation of the rectus femoris muscle during exercises performed on the leg press.

The rectus femoris was analysed in 10 volunteers during knee flexion and extension with the feet in normal, plantar flexion and dorsal flexion positions. Hewlett-Packard surface electrodes, an electromyographic signal amplifier, a computer equipped with an A/D conversion plaque (Model CAD 10/26), software specially designed to record and analyse the signals, Horizontal Leg Press, and electrogoniometers were used. The rectus femoris muscle showed strong potentials at the beginning of knee extension. In the simultaneous bending of the knee and hip the activity was strong toward the end of the movement. The rectus femoris showed a similar activity both in the upper and lower platforms. As for foot positions, the rectus femoris showed the smallest potentials with the foot in plantar flexion and the largest ones with the foot in dorsal flexion.

[Anthrax meningoencephalitis: a case following a cutaneous lesion in Morocco]. / Atteinte cérébroméningée de la maladie de charbon: à propos d'un cas à point de départ cutané au Maroc.

Anthrax meningoencephalitis is very rare especially following skin location. We report a case of meningoencephalitis secondary to skin lesion. The diagnosis is based on clinical presentation and confirmed by microbiological tests. Its evolution remains fatal despite aggressive resuscitation.

Clinical and immunological status of a newly diagnosed HIV positive population, in Marrakech, Morocco.

OBJECTIVE: To evaluate the clinical and the immune status of newly HIV diagnosed patients, in Marrakech city and its neighboring area, in Morocco. METHODS: We performed a retrospective study on 235 patients who have been previously confirmed for HIV infection, and underwent a CD4 T cells using flow cytometry (FacsCount, Becton Dickinson®). RESULTS: The mean age of patients was 34,3 ± 8,4 years (range: 14-55), with a male predominance (sex-ratio M/F=1.4). On basis of clinical data of the patients, 62% (n=146) of them were categorized as "category C", 18.4% (n=43) as "category B", and 19.6% (n=46) as "category A" according to CDC (Center for Disease Control) HIV classification. Among all of them, 60.4% (n=142) had less than 200 CD4T cells, 26% (n=61) had between 200 and 499 CD4T cells, and only 13.6% (n=32) showed a number of CD4T cells less or equal to 500/mm(3). CONCLUSION: The results of this study reflect a significant delay in the diagnosis of HIV infected patients. Therefore, this delay may compromise timely management of HIV infected individuals and enhances propagation of the epidemic in our country. These data confirm the need for intensifying prevention efforts among high-risk population. Moreover, continuing education in HIV/AIDS among healthcare providers should be reinforced.