[Epidemiological and tomodensitometric aspects of post-traumatic maxillofacial fractures in Mopti, Mali]. / Profil épidémiologique et tomodensitométrique des fractures maxillo-faciales post-traumatiques à Mopti au Mali.

Introduction: facial injuries are a public health problem, both physically and psychologically, characterized by a variety of injuries and sometimes by severe esthetic or functional sequelae. The purpose of this study was to describe the epidemiological and tomodensitometric aspects of maxillofacial fractures in Mopti. Methods: we conducted a cross-sectional and descriptive study in the Department of Radiology of the Mopti Hospital from January 2019 to December 2019. All patients who had undergone maxillofacial CT scan for a trauma with fracture confirmed by CT scan during this period were included. The variables analyzed were age, sex, etiology and the types of fractures observed on CT scan. Data recording and analysis were carried out using SPSS version 20 and Excel 2013. Results: of a total of 120 patients, the mean age was 26.43 years with a standard deviation of 14.547. Men predominated (75%; n= 90). Road accidents were the leading cause of fractures (50%; n = 60). Occlusofacial fractures accounted for 38.33% (n= 46). Lefort II was the most common fracture (22.50%; n= 27). Conclusion: this study allowed us to identify the population groups most affected by maxillofacial fractures in the Mopti region: adolescents and young adults. Tomodensitometric results were dominated by occlusofacial fractures, in particular Lefort type II fractures.

[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.

[Medico-Surgical treatment of mycetoma in the Somine Dolo hospital of Mopti (Mali)]. / Prise en charge médico-chirurgicale des mycétomes à l'hôpital Somine Dolo de Mopti (Mali).

Objective: The objective of this study was to describe the epidemiological and clinical aspects as well as the therapeutic methods of mycetomical lesions. Material and Methods: This was a longitudinal retrospective study, which included all patients treated for mycetoma from January 2016 to December 2018 including two years of recruitment and one year of monitoring (2019). The study concerned 19 patients who were hospitalized and treated in the department of surgery. Results: Patients represented 2.3% of hospitalizations and consisted of 11 males and 8 females with an average age of 38 years with extremes of 15 - 70 years, and an average time between the onset of symptoms and presentation to the hospital of 10 years (range 1 - 40 years). Eight livestock breeders and seven farmers were concerned, 14 of whom have started the disease after trauma. The foot was involved in 13 patients. Twelve suffered from osteoarticular lesions. Black grains were present in 16 cases attributed to Madurella sp. We performed 12 amputations, six carcinological ablation to which specific local treatments were added (thin skin graft in two patients, fasciocutaneous flap in one patient and directed healing in the others) and local treatment in the last case. Conclusion: Mycetoma should be discussed and diagnosed at an early stage in predisposed patients particularly in farmers and breeders. Prevention is necessary; it is based on wound disinfection and wearing safety shoes.

[Ct scan diagnosis of polyostotic fibrous dysplasia with maxillofacial dysmorphia: a case report]. / Diagnostic tomodensitometrique d'une dysplasie fibreuse polyostotique avec dysmorphie maxillo-faciale : a propos d'un cas.

We report a rare case of polyostotic fibrous dysplasia with maxillofacial dysmorphia diagnosed in the radiology department at Hopital Sominé Dolo of Mopti. The aim was to describe the role of medical imaging including the CT scan in its diagnosis. He was a 42-year-old man of rural origin with poor socio-economic conditions. He was sent to us for a craniofacial CT scan for assessment of a maxillofacial mass. This CT scan showed a thickening of the diploid of the vault and the cranial base with osteocondensation and osteolytic lesions at the maxillofacial level. An extension assessment showed polyostotic involvement. His diagnosis is based on medical imaging and in particular CT scan. Three types of radiological aspects are evocative: a homogeneous or heterogeneous clarity, a smoke-like appearance and a slightly condensed appearance. Complications observed were deformities, fracture of the femoral neck and aesthetic damage.

Nous rapportons un cas rare de dysplasie fibreuse polyostotique avec dysmorphie maxillo-faciale diagnostiqué au service de radiologie à l'hôpital Sominé Dolo de Mopti. Le but était de décrire le rôle de l'imagerie médicale notamment le scanner dans son diagnostic. Il s'agissait d'un homme âgé de 42 ans, de provenance rurale avec des conditions socio-économiques défavorables. Il nous a été adressé pour un scanner crâniofacial pour bilan d'une masse maxillo-faciale. Cette exploration scanographique avait objectivé un épaississement du diploé de la voûte et de la base crânienne avec ostéocondensation et des lésions ostéolytiques soufflantes au niveau maxillo-facial. Un bilan d'extension a objectivé une atteinte polyostotique. Son diagnostic repose sur l'imagerie médicale et en particulier la tomodensitométrie. Trois types d'aspects radiologiques sont évocateurs: une clarté homogène ou hétérogène, un aspect en volutes de fumée et un aspect légèrement condensé. Les complications observées étaient les déformations, la fracture du col fémoral et le préjudice esthétique.

Effect of water source and feed regime on development and phenotypic quality in Anopheles gambiae (s.l.): prospects for improved mass-rearing techniques towards release programmes.

BACKGROUND: In many malaria-endemic sub-Saharan countries, insecticide resistance poses a threat to existing mosquito control measures, underscoring the need for complementary control methods such as sterile and/or genetically-modified mosquito release programmes. The sibling species Anopheles gambiae and An. coluzzii are responsible for malaria transmission in most of this region. In their natural habitat, these species generally breed in clean, soft water and it is believed that divergent preference in their larval breeding sites have played a role in their speciation process. Mosquito release programmes rely on the rearing of mosquitoes at high larval densities. Current rearing protocols often make use of deionised water regardless of the strain reared. They also depend on a delicate balance between the need for adequate feeding and the negative effect of toxic ammonia and food waste build-up on mosquito development, making managing and improving water quality in the insectary imperative. METHODS: Here, we investigated the impact of water source and feed regimes on emergence rate and phenotypic quality of mosquitoes in the insectary. First-instar larvae of An. gambiae (Kisumu strain) and An. coluzzii (Mopti and VK3 strains) were reared in three water sources with varying degrees of hardness (deionised, mineral and a mix of the two), with a daily water change. Larvae were fed daily using two standardised feeding regimes, solution and powder feed. RESULTS: Water source had a significant impact on mosquito size and development time for all strains. Earlier emergence of significantly larger mosquitoes was observed in mineral water with the smallest mosquitoes developing later from deionised water. Wing-length was significantly longer in mineral, mixed water and in powder feed, irrespective of sex, strains or water types. Deionised water was the least favourable for mosquito quality across all strains. CONCLUSIONS: Mineral water and powder feed should be used in rearing protocols to improve mosquito quality where the optimal quality of mosquitoes is desired. Although results obtained were not significant for improved mosquito numbers, the phenotypic quality of mosquitoes reared was significantly improved in mineral water and mix water. Further studies are recommended on the impact mineral water has on other fitness traits such as longevity, fecundity and mating competitiveness.

Kaposi's disease in an HIV positive child, with probable contamination from his grandmother.

Kaposi's disease in children with HIV is rarely reported in everyday practice. This is a case study of cutaneous Kaposi's disease revealing HIV in a 5-year-old child with polymorphic eruption of papules and nodules on the face, trunk, back, and limbs. Histopathological examination confirmed the diagnosis of Kaposi's disease. The child's HIV serology was positive with a CD4 count of 240/mm3, normochromic and normocytic anemia, and a hemoglobin level at 8.5 g/dl. It was found that the child, after early weaning from his HIV-negative mother, had repeatedly suckled his healthy grandmother, who had no skin lesions but was HIV1 positive. Both grandmother and child were referred for treatment in their locality. The case is noteworthy for the way in which the HIV1 virus infected the child during weaning and then being suckled by his grandmother. The child already had an initial dental flare that could have injured his grandmother. Thus, in our case, there is a contamination by HIV1 virus most likely from the grandmother and contamination by the HHV8 virus, source unidentified as a technical plateau was reached.

[Acute generalized peritonitis in Sominé Dolo's Hospital of Mopti: Epidemiologic and therapeutic aspects]. / Peritonites aiguës Generalisees a l'hopital Somine Dolo de Mopti: Aspects epidemiologique et therapeutique.

Acute generalized peritonitis requires precocious diagnosis and immediate treatment. MATERIALS AND METHODS: The purpose of this study is to determine hospital case frequency, to describe the clinical and therapeutic aspects and to evaluate the operating suites. We conducted a prospective study, lasting 16 months, from January 2005 to April 2006, looking at 40 cases of generalized acute peritonitis operated in several services, including a general surgery department, of the Sominé Dolo's hospital of Mopti. RESULTS: We noted a hospital admittance rate of 3.1% with an average age of 26.3 years old and a 1.66 men to women ratio. Peritonitis at the Sominé Dolo hospital was dominated by intestinal perforation. The diagnosis was essentially made using the clinical approach. The treatment was medico-surgical. Operative mortality was recorded in 7 cases (17.5%) with 7 cases of inner-wall abscesses. The delay of consultations and the Mannheim score were the main factors causing bad prognostics. Excision - sutures associated with a cleansing drainage of the abdominal cavity was the most practised surgical procedure. CONCLUSION: Mortality remains high. The two factors for a bad prognostic are the delay of consultation and the lack of means for reanimation.

INTRODUCTION: La péritonite aiguë généralisée est une urgence qui nécessite un diagnostic précoce et un traitement d'urgence. MATÉRIELS ET MÉTHODES: Nous avons réalisé une étude prospective de seize mois de janvier 2005 à avril 2006 portant sur 40 cas de péritonites aigues généralisées opérés à l'hôpital Sominé Dolo, qui est un hôpital de première référence de la région de Mopti avec plusieurs services dont un service de chirurgie générale. Les objectifs de cette étude étaient de déterminer la fréquence hospitalière, de décrire les aspects cliniques, thérapeutiques et évaluer les suites opératoires. RÉSULTATS: Nous avons eu une fréquence hospitalière de 3,1% avec un âge moyen de 26,3 ans et un sex-ratio de 1,66 pour les hommes. La péritonite à l'hôpital Sominé Dolo de Mopti a été dominée par la perforation intestinale. Le diagnostic a été établi essentiellement sur la clinique. Le traitement a été médico-chirurgical. La mortalité opératoire a été observée dans 7 cas (17,5%) avec 7 cas d'abcès de paroi (17,5%). Le retard de consultation et le score de Mannheim ont été les principaux facteurs de mauvais pronostic. L'excision ­ suture associée à un lavage drainage de la cavité abdominale ont été les gestes chirurgicaux les plus pratiqués. CONCLUSION: La mortalité reste élevée .Les deux facteurs de mauvais pronostic ont été le retard de consultation et le manque de moyens de réanimation.