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Objectifs : Notre étude avait pour objectif de décrire les caractéristiques sociodémographiques, cliniques, paracliniques, thérapeutiques et évolutives des PVVIH hospitalisées à l’hôpital régional de Thiès. Patients et méthode : Il s’agit d’une étude rétrospective descriptive à partir des dossiers de PVVIH hospitalisées à l’hôpital régional de Thiès du 1er janvier 2010 au 31 décembre 2015. Les données ont été saisies puis analysées grâce au logiciel Epi info 3.5.4. Résultats : Nous avons colligé 101patients VIH positif. Le sex ratio M/F était de 0,56 et l’âge moyen des malades de 43 ans ± 10,5 ans avec des extrêmes de 15 et 78 ans. La quasi-totalité de nos malades résidaient dans la région de Thiès (82,3%). Dans la majorité des cas, le statut sérologique des patients était connu avant l’hospitalisation (78,2%) et 71,9% des patients étaient en état d’immunodépression sévère (taux de CD4

Cet article fait apparaître l'intérêt d'une approche graphique - la méthode des courbes de résidus - dans une étude préliminaire de faisabilité d'une distillation réactive. Dans un premier temps, nous mettons au point un outil de calcul permettant de générer les courbes de résidus pour un système multicomposant, siège d'une ou plusieurs réactions chimiques. Ces courbes de résidus donnent une idée précise de l'existence de barrières de distillation et les caractéristiques limites de séparation par distillation. Dans un deuxième temps, par analyse de ces courbes, nous établissons une méthode d'évaluation de la faisabilité d'une distillation réactive. Partant d'une alimentation (F) de composition fixée, nous définissons un domaine de composition dans lequel vont se situer les produits. Inversement, pour une pureté de produit définie, nous quantifions les valeurs limites de la composition de la charge permettant d'y parvenir. Un exemple d'application est présenté pour la réaction d'éthérification de l'isobutène par le méthanol en présence d'un composant inerte. This article demonstrates the usefulness of a graphical approach - the residue curve method - in a preliminary feasibility study of a reactive distillation process. First, we refine a calculation for generating the residue curves for a multicomponent system in which one or more chemical reactions can occur. These residue curves give both a precise idea of whether there are distillation barriers and the limits to separation by distillation. Then, analyzing the curves, we derive a method for evaluating the feasibility of reactive distillation. Starting with a fixed-composition feedstock (F), we define a range within which the products will be found. Conversely, to achieve a given product purity, we determine the limits within which the feedstock composition must fall. A practical example, the conversion of isobutene into ether by methanol in the presence of inert material, is presented.

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Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction En France, devant une personne d’origine étrangère sans carnet de vaccination, l’attitude varie entre un rappel ou une vaccination complète et les recommandations ne sont pas standardisées. L’utilisation du test rapide tétanos ou tétanos quick stick (TQS, INGEN ® ) pourrait avoir une place dans la stratégie de rattrapage vaccinal. L’objectif de l’étude est d’évaluer son intérêt pour orienter le rattrapage vaccinal chez les personnes sans carnet de vaccination. Matériels et méthodes Entre avril 2015 et décembre 2016, 2684 personnes de plus de 5 ans ont été vaccinées au centre de vaccination. Vingt-quatre pour cent (643) n’avaient pas de carnet de vaccination. Parmi elles, nous avons étudié les 543 personnes nées hors d’Europe pour lesquelles se posait la question d’une vaccination complète ou d’un simple rappel et retour dans le calendrier vaccinal. Un TQS fut réalisé pour chacun d’entre eux associé à un recueil des antécédents de vaccin anti-tétanique. En cas de TQS positif, un rappel vaccinal était réalisé. En cas de TQS négatif, une sérologie tétanos (Virotech EIA, Sekisui) un mois après le rappel était réalisée afin de mesurer la capacité discriminante du TQS pour la poursuite ou non du schéma complet. La vaccination complète ne fut réalisée que si le taux était < 1 UI/mL. Résultats Au cours de la période d’étude, 396 adultes et 147 enfants furent inclus dans l’étude. Parmi eux, 263 rapportaient un antécédent vaccinal contre le tétanos alors que le TQS était positif chez 286 adultes (72 %) et 82 enfants (56 %), orientant la stratégie de rattrapage vers un rappel unique. Chez les 116 adultes et 65 enfants dont le TQS était négatif, posant la question de la réalisation d’une vaccination complète ou d’un rappel, la sérologie quantitative tétanos montrait un taux supérieur à 1 UI/mL chez 61 patients adultes (73,5 %) et 43 enfants (87,8 %) témoignant d’une vaccination antérieure. L’interrogatoire à la recherche d’une vaccination antérieure n’était pas discriminant : 11/53 patients (20,8 %) attestant d’un antécédent vaccinal présentaient un taux post-dose unique < 1 UI/mL et 47/60 patients (78,3 %) attestant d’une non vaccination antérieure présentaient un taux post-dose unique > 1 UI/mL. Conclusion Parmi les personnes étrangères consultant un centre de vaccination sans carnet de vaccination, 67,7 % (368/543) ont une trace objective de vaccination antérieure avec un TQS positif permettant de réaliser un simple rappel. En revanche un TQS négatif ne permet pas de discriminer entre une absence totale de vaccination et une vaccination antérieure. Une sérologie quantitative post-dose unique est nécessaire afin de ne réaliser la vaccination complète que chez 21,7 % (28/129). Ce schéma incluant TQS et sérologie post-dose si TQS négatif pourrait orienter de façon objective la conduite à tenir chez les personnes nées hors de France sans carnet de vaccination. [ABSTRACT FROM AUTHOR]

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., (Copyright © 2021 SFMTSI.)

Objectives: Specify epidemioclinical and legal aspects of sexual abuse among minors and evaluate the cost of care in Dakar., Materials and Methods: This is a retrospective multicenter cross-sectional study on sexual abuse among minors over a period of four years from 1st January 2006 to 31st December 2009. Four maternities were targeted: the Social Hygiene Institute of Medina, health center Roi-Baudouin Guédiawaye, the Pikine hospital and health center Youssou-Mbargane-Diop of Rufisque., Results: During the study period, 252 child victims of sexual abuse were supported at four health facilities on a total of 272 sexual abuses of all ages, a frequency of 92.64%. The epidemiological profile of our patients was a child of 11 years old on average, female (100%) and living in the suburbs of Dakar (68.1%). Children were often abused during working hours (31.7%), outside the family environment and often by someone known to the victim (72.6%). Genito-genital contact was the most common mode of sexual contact (80.9%) with vaginal penetration in 61% of cases. Almost all of the victims (92.1%) came to consult, accompanied by their parents, between the 1st and 4th day after the sexual abuse (70%). The examination usually revealed a hymenal trauma (59.9%) of which nearly half (49%) consisted of old lesions. 56.9% of victims had a post-traumatic stress disorder and 31.1%, mutism. We recorded six (6) pregnancies, 2% of our sample. A case of HIV infection was recorded on a sample taken 72hours after sexual abuse. Control of three months HIV serology was requested in 7.1% of cases and only 20% of children had received antiretroviral prophylaxis. Antibiotic prophylaxis had been performed in 13.7% of cases using doxycycline as drug of choice (75%). Only 29% of our patients had received emergency contraception progestin and psychological care concerned only 22% of children. On the legal aspects, 46% of our patients had filed a complaint. Prosecutions were 38%, 45% of which were convicted and 21% were acquitted. The rate of out-of-court settlement was 35% and the time limit for settlement by the justice was on average 6 months with extremes of one month and 24 months. The average cost of care was estimated at 17,010 CFA francs (26 euros) taking into account the consumables used for clinical examination (sterile gloves, catheter, syringe), analysis and prescription drugs., Conclusion: The sexual abuse of minors is a disturbing reality that raises rightly universal reprobation. In Senegal, this mainly affects children and its magnitude is increasing over the years. Improved support for victims necessarily involves raising public awareness through the media and the development of specialized structures in the management of sexual abuse., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Objectives: To determine unmet needs formajor obstetric interventions and evaluatematernal and perinatal outcome in the region of Dakar in 2010., Materials and Methods: This retrospective, descriptive, and analytic study of major obstetric interventions (MOI) for absolute maternal indications (AMI) in Dakar examined records in the reference health centers and public hospitals in Dakar for 2010., Results: During the study period, we recorded 5 383 MOI. The epidemiological profile of patients was a woman with a mean age of 28 years, primiparous (41.1%), married (99.7%), and living more than 10 km from the clinic (51%). AMI accounted for 3 449 of the MOI. Cesarean deliveries were by far the predominant intervention (98.74%). Fetal-pelvic disproportion was the most frequent AMI in our study (75.85%). Because the expected number of MOI for AMI in Dakar was 2123, we estimated an unmet obstetric need (UON) of 1326 IOMs, that is, -62.45%of the excess number of IOMs, with disparities between districts. Of 22,349 deliveries, 47 mothers died (0.21%), mainly from antepartumand postpartum hemorrhages (59.6%) and preeclampsia/eclampsia (23.4%). In all, in 22,349 births, there were 442 deaths (2%)., Conclusion: Obstetric needs are generally well supported in Dakar. However, this negative deficit recorded may mask a real obstetric need.

Introduction: Despite the importance of prenatal care to decrease maternal and neonatal mortality, uptake remains suboptimal in Burkina Faso. This article documents the reasons for non-uptake of prenatal care, by focusing on women who either completely renounce or delay their access to prenatal care., Methods: Qualitative data collection was performed in the rural town of Kokologho from October 2013 to january 2014. Different collection methods were used: participant observation, twenty-two individual semi-structured interviews with women who accessed prenatal care as a late option and eight informal interviews with key informants identified in the community., Results: Thematic analysis revealed four barriers against the effective use of prenatal care by women: (1) lack of knowledge about the prenatal care schedule and purpose (2) perception of pregnancy and prenatal care (3) socioeconomic barriers: direct payment for prenatal care and the limited autonomy of women, and (4) perception of the quality of prenatal care., Discussion: Based on these observations, non-uptake of prenatal care is discussed using different types of explanatory typologies adopted for this study: non-knowledge, non-claiming by choice or constraints and non-reception of care. This theoretical approach reveals that failures in healthcare services as well as the dichotomy between social representations and medical standards of pregnancy and prenatal care contribute to exclude some women from the prenatal care system.

Malaria remains a major problem in African countries despite substantial decreases in morbidity and mortality due to sustained control programs. Studies for the evaluation of qualitative or quantitative Ab responses to key targets of anti-plasmodium immunity were mostly done in rural endemic setting compared to urban area. In a cohort of 200 patients with mild malaria and living in Dakar, we analyze total and subclasses IgG responses to a panel of P. falciparum blood stage antigens: MSP1p19, MSP3, EB200, GST-5 and R23. A mean age of 15 yrs (4 to 56 yrs) and parasitemia between 0.1 to 17% were found. Levels of IgG anti-MSP3 were higher in patients with low parasitemia (≤1%) and appear negatively correlated to parasite densities (Rho =. 0.54; p= 0.021). This correlation is more significant in children (≤ 15 yrs). In addition, an increase of IgG responses against MSP1p19 is highly observed in adults having a parasitemia less than 1%. In those patients, we find that IgG1 subclasses were predominant (p <0.01). Our study shows an association between Ab responses and parasitemia. This association is dependant to IgG anti-MSP3 in children and IgG anti-MSP1p19 in adults living in urban area.

Influenza surveillance in Senegal was initially restricted to the identification of circulating strains. The network has recently been enhanced (i) to include epidemiological data from Dakar and other regions and (ii) to extend virological surveillance to other respiratory viruses. Epidemiological data from the sentinel sites is transmitted daily by mobile phone. The data include those for other febrile syndromes similar to influenza-like illnesses (ILI), corresponding to integrated approach. Also, clinical samples are randomly selected and analyzed for influenza and other respiratory viruses. There were 180,192 declared visits to the 11 sentinel sites between week 11-2012 and week 52-2013; 24% of the visits were for fever syndromes and 25% of the cases of fever syndrome were ILI. Rhinoviruses were the most frequent cause of ILI (19%), before adenoviruses (18%), enteroviruses (18%) and influenza A viruses (13%). Co-circulation and co-infection were frequent and were responsible for ILI peaks. In conclusion, it is clear that the greatest advantage of this system is the ease with which it can be implemented, thanks to the availability of mobile phones and mobile phone networks. We recommend this solution for other African countries, because it performs very well and provides rapid benefits in terms of public health decision-making.

Objectives: To demonstrate the feasibility of copper IUD insertion following cesarean deliveries and assess its safety., Patients and Methods: This is a prospective pilot study at Pikine national hospital from February 15 to November 15, 2012. Were evaluated the efficacy, incidence and spectrum of complications and continuation rates., Results: Fifty-nine subjects were enrolled and 46 received an IUD. The average age of patients was 28 years. No patient had previously used IUDs. Forty-four patients (97.5%) were returned to the first follow-up visit at the first month, 41 patients (89.1%) at the second visit and 39 patients (86.9%) at the third visit. The rate of lost sight was 8.7%. Pain and bleeding were reported rarely: 2.3% at the first month, 4.9% at the third month and 7.7% at the sixth month for the bleeding and 6.8% at the first month, 2.4% at the third month and 2% at the sixth month for pain. The rate of expulsion was 2.2%., Conclusion: The insertion of the IUD following cesarean delivery has an acceptable rate of expulsion and no increased rate of adverse effects. This technique should be popularized., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Our work aimed to propose a manual method of counting CD4 T lymphocytes which is an alternative magnetic immunoseparation followed by a reading with a fluorescence microscope as an alternative to the automated flow cytometry. This alternative technique is easier for use, less expensive and could answer the difficulties encountered for the monitoring CD4 T cells count in developing countries. The specific objectives were: 1) to train the technicians of the peripheral sites in order to make the numeration of the CD4 T lymphocytes more accessible at the peripheral level; 2) to equip the sites with necessary facilities for the T lymphocytes CD4 count; 3) to put in place a system of quality control permitting the reliability of the results. A hundred and fifty patients have been enrolled in three care services for people living with HIV/AIDS in Dakar. This population was constituted of 119 seropositive and 31 seronegative patients acting as control group to have some patients with high rates of T lymphocytes CD4. For the follow-up at peripheral level, the patients were constituted of the active line of the patients living with HIV/AIDS supported in the targeted sites. The measurements allowed studying concordances for different rates of lymphocytes: 0 to 199, 200 to 499 and over 500 cells by mm3. The results showed also a very good correlation (r = 0.97 or r = 0.98 according to the operator) between the two methods for CD4 rates inferior to 500 cells by mm3 among both the negative group and the HIV positive patients. We also discussed the profit of decentralization for the program and the patient, as well as the setting up of an external quality control to validate the alternative technique. According to the results, the Dynabeads is well correlated with the Facscount. It is a technique that can be used as an alternative in the zones with limited resources, low prevalence and for a small number of samples.

Introduction: The calcitonin is the most specific and the most sensitive marker of medullary thyroid carcinoma (MTC) both for screening and postoperative follow-up of the patients. Its measurement is made either remotely , or after stimulation of pentagastrin secretion which the answer is amplified at the carrier of CMT. The aim of this study was to estimate a chimioluminescent method by comparing it with an immunoradiological method, manual, used as reference. Correlation study was done., Materials and Methods: Two hundred and sixty three serums (263) were tested among which 64 resulting of healthy subjects and 199 resulting of patients affected) by medullary thyroid carcinoma. Statistical analysis of results was made by a study of correlation with the software OriginLab version 7.0. The manual technique used as reference method is radioimmunological (Elsa hCT, international Cisbio, Gif on Yvette, France). It was compared with a chimioluminescent technique (Nichols Advantage, Nichols Institute Diagnostics, CA, the USA)., Results: The coefficients of correlation obtained between both tests were: r = 0.76 (exactness study), r = 0.91 (after stimulation), r = 0.95 and 0.79 (staged samples), r = 0.99 (M TC patients)., Conclusions: Both techniques correlate strictly and significantly. The correlation coefficients we obtained show us that Nichols Advantage Calcitonin is completely reliable and sensitive for the measurement of the hCT in the follow-up of the CMT.

Introduction: Serum thyroglobulin measurements play an integral role in clinical evaluation of patients with thyroid cancer. Serum thyroglobulin is a highly specific and sensitive tumor marker for detecting persistent or recurrent thyroid cancer but also for monitoring clinical status. Actually, chemiluminescent methods gain ground on the radioimmunological methods because they offer the practical advantage of a shorter incubation time, a wider range of measured values and a reagent marked antibody more stable, less fragile than those used on radioimmunoassay. The aim of this study was to compare, by correlation study, three chemiluminescent methods to the reference radioimmunological method usually used in laboratories., Materials and Methods: Thyroglobulin was measured in 203 patients by the 3 following analyzers: Nichols Advantage (Nichols Institute Diagnostics, CA, USA), Immulite 2000 ( DPC Roche, Siemens, Los Angeles, USA) and Elecsys 2010 (Roche Diagnostics, Manheim, Germany); and by manual method (SELco Tg (Medipan Diagnostica, Berlin, Germany). Correlation analysis with OriginLab software version 7.0 was performed in order to compare thyroglobulin distribution values measured by the different methods., Results: Correlation coefficients obtained were for Medipan/ Immulite 2000: 0.95 (n = 80); for Medipan/Elecsys: 0.97 (n = 31); for Medipan/Advantage: r = 0.96 (n = 73)., Conclusions: Chemioluminescent technics we studied could be validly used in patients without anti-thyroglobulin antibody. The correlation coefficients we obtained allow us to select one of these automated methods after their performance was studied.

Sickle cell anemia does not cause martial deprivation per se, but may worsen when iron deficiency exists, notably in tropical zone where infectious diseases and malnutrition are endemic mainly during childhood. This study was aimed to assess iron deficiency prevalence among children with sickle cell disease (SCD) and to determine the best parameters for its diagnosis. In addition to classical parameters, we measured transferrine's soluble receptors which can reveal an iron deficiency, either isolated or associated to another condition since its level is not influenced by chronic anemia. Assays were carried out in 40 homozygous SCD patients, aged 3 to 18 years, having an hemoglobin level < 11 g/dL and in 30 age-paired controls assumed to be healthy and having a negative Emmel test and an hemoglobin level < 11 g/dL. The results showed hyposideremia (serum iron < 60 microg/dL) in 17.5% of the patients. Ferritinemia, transferrinemia as well as total iron fixation capacity were in the normal range for the majority of SCD patients in spite of the frequency of hyposideremia and microcytic anemia (20%). Transferrine's saturation coefficient was low in 22.5% of patients, which can be due to martial deprivation or to inflammatory status. These results confirm the limitations of usual biochemical parameters in the diagnosis of iron deficiency in homozygous drepanocytosis. Soluble receptors' levels were increased in 60% of controls; that proves that iron deficiency prevalence is high in our countries. Higher levels were found in 97.5% of patients. However, receptors' levels are increased during haemolysis, thus it is difficult to ascertain the origin of the increase, but taking into account its index value can reduces misinterpretation. In addition, considering simultaneously microcytosis, hypochromia, transferrine's soluble receptor level and its index, we can speculate that martial deficiency occurs in 20% of SCD patients, a percentage close to the 17.1% obtained by other authors using only the combination of microcytosis and hypochromia. It results from this study that associating microcytosis and hypochromia could validly assess iron deficiency during drepanocytosis., (Copyright John Libbey Eurotext 2003.)

Nephropathy is one of the complications occuring during diabetes and it is diagnosed via microalbuminuria. From 1992 to 1999, five hundred and eighty seven (587) diabetic patients were recruited and distributed into two groups, A (n = 270) and B (n = 317). Microalbuminuria was determined by immunonephelemetry for group A and immunoturbidimetry for group B. The results showed respectively 15.5% and 20.19% pathological cases in the two groups (NS). Considering the distribution of patients with microalbuminuria according to the type of diabetes, there were 16.12% type 1 and 15.07% type 2 in group A against 22.60% and 18.13% in group B; no statistically significant differences were observed either in the same group or from one group to another. These frequencies might reflect the situation in the nineties; they are lower than those encountered in other populations. Nevertheless monitoring is needed through a regular schedule to prevent nephropathy.

Two major outbreaks of meningitis due Neisseria meningitidis serogroup A occurred in Senegal in 1998 and 1999. The purpose of this report is to describe clinical, bacteriological and therapeutic findings in 70 patients admitted for cerebrospinal meningitis to the Infectious Disease Clinic at the Fann University Teaching Hospital in Dakar in 1999. Diagnosis was based on direct microscopic examination after Gram staining in 71% of the cases, culture in 76%, and detection of soluble antigens in cerebrospinal fluid in 24%. Median patient age was 20 years. The highest incidence, i.e. 66% of cases, was recorded during February, March and April. Meningitic syndrome and fever were observed with 86% of the cases. The average duration of antibiotic therapy was 8 days. Chloramphenicol was the most commonly used drug (84% of cases). All strains identified in cultures were sensitive to chloramphenicol, ceftriaxone and cefotaxime but resistant to cotrimoxazole. Outcome was favorable in 93% of the cases. Three patients (4%) died and two (3%) developed hearing loss. Despite the low death rate in this series of patients treated in a hospital setting, mass vaccination is still the most effective mean of controlling meningococcal meningitis.

The aims is to evaluate fertility and medical cost about post ectopic pregnancy follow up. It is about a retrospective and descriptive study about 337 patients who have the opportunity to get a salpingectomy for an ectopic pregnancy between 1989 and 1997 at Le Dantec Gynecological and Obstetrical Clinic. After the ectopic pregnancy cure, women are followed with contraception, just time before trying to obtain another pregnancy. The studied parameters are: age, parity, socio-economical status, level of instruction, obstetrical and gynecological antecedents, Chlamydia serology, hysterosaipingography data, fertility after ectopic pregnancy, fees related to the cost of follow up after ectopic pregnancy. Data exploitation is done through an epidemiologic programme named Epi Info version 5 The average age of the patients was 27 years and that of the parity was 2.70. 87.83% of women were married. More than the half of those patients came from the suburb of Dakar. 171 patients (50.74%) were followed regularly, the other 166 (49.26%) disappeared. A Chlamydia trachomatis infection was found among 23.4% of cases. A tubal obstruction was noted in the level of the horns at 12.5 % of women. No case of maternal death was observed. Among 59 patients who wished a pregnancy, 34 ectopic pregnancy had been obtained (57.62%) in 4 month after stopping contraception and 26 cases of a new ectopic pregnancy. The expenses of medical cure after ectopic pregnancy are about 17.814 to 71,574.65 F CFA with an average of 38,689 F CFA (389.89 FF). Medical care after ectopic pregnancy raises a lot of problems: --some patients disappeared probably because of the inaccessibility of financial cost, --the high rate of Chlamydial trachomatis infection, an hypofertility after ectopic pregnancy. To combat this, we have to insist in the prevention of sexually transmitted diseases in general and of the chlamydial infection in particular. We have also to insist in the early diagnosis of the ectopic pregnancy. At last, we must set up a registre of ectopic pregnancy at the national level.

Nephropathy is one of the complications occuring during diabetes diagnosed via microalbuminuria. From 1992 to 1999, five hundred and eighty seven (587) diabetic patients were recruited in groups A (n = 270) and B (n=317). Microalbuminuria was determined by immunonepheletry for A and immunoturbidimetry for B. The results pointed out respectively 15.5% and 20.19% pathological cases (NS). Considering the distribution of patients with microalbuminuria according to the type of diabetes there were 16.12% type 1 and 15.07% type 2 in group A against 22.60% and 18.13% in group B ; no stastically significant differences were observed either in the same group or from one group to another. These frequencies would reflect the situation in the nineties; they are lower than those encountered in other populations. Nevertheless monitoring is needed through a regular schedule to prevent nephropathy.

Candidiasis are very usual infections of HIV infected patients. By medicine pressure, susceptibility to antifungal drugs decrease in some Candida strains. This study carded out in 1997 at hospital, aimed to identify the yeast species isolated from HIV infected patients with oropharyngeal candidiasis, test their susceptibility to antifungal drugs and a previous antifungal treatment impact. Thus, 60 patients yielded to questionnary were recruited. Isolated yeast colonies from buccal tract after culture on Sabouraud medium with chloramphenicol were identified with the API 20 C AUX (BioMérieux) system by assimilation of different sugars. Susceptibility was evaluated by ATB FUNGUS (BioMérieux) system. 55 from the 60 isolated yeasts were identified and among them C. albicans and C. tropicalis were the main species with 75% and 11,7% respectively rates. In HIV1 infected patients, all specieswere isolated and C. albicans predominated (80,4%) on the other hand, C. albicans and C. tropicalis were the only isolated yeasts from the HIV2 infected patients with 83,3% and 16,6% respectively rates. Susceptibility of C. albicans was 72,2% to nystatine, 58,3% to amphotericin B, 83,3% to flucytosin, 12,8% to miconazole, 8,5% to econazole and 10,6% to ketoconazole. Susceptibility of C. albicans to polyenes was modified by a previous antifungal treatment. This study indicated emergence of saprophytic yeasts of the buccal mucosa and seemed to be more fostered by HIV1 serotype than HIV2. So, C. albicans's susceptibility to polyenes decreased by untimely use of antifungal drugs and by controlling it one could improve the clinic conditions of HIV infected patients.

This work studies the thyroid disorders impact on adrenals glands by measuring total cortisol. Radioimmunoassays of thyroid hormones and cortisol were performed in 108 subjects, aged 20-52 years, with thyroid diseases. Our results show low cortisol values (80.35 nmol/L) in 4.77% of hyperthyroids, high values in 3.57% of hyperthyroids (1348.18 nmol/L) and 12.5% of hypothyroids (969.05 nmol/L). In hyperthyroidism, thyroid hormone stimulates the secretion of 11 ceto metabolites biologically inactive, unable to slow pituitary activity, inducing an increased production of endogene cortisol. Excessive catabolism can lead to the exhausting of overstimulated adrenal glands, and therefore to a decreased cortisol. In hypothyroidism, high cortisol results of increase cortisol half life and decrease of metabolic clearance. Control mechanisms often allow normal cortisol values. These alterations in functional activity of adrenal glands, seen in nearly 10% of these subjects, sometimes command a specific attitude in diagnosis and therapy.

This study concern a survey of bacterial resistance to cotrimoxazole; 510 strains of Enterobacteria (167), Vibrio cholerae(206) and Staphylococcus aureus(137) were tested by disc diffusion and agar dilution methods. An interview was conducted with 86 health personals to appreciate the influence of prescription. Staphylococcus aureus were the most susceptible bacteria (13% of resistance), and Vibrio cholerae the most resistant (95%). Related to the gender, Enterobacteria present 43 to 72% of resistance. The data of interview show a very frequent use of cotrimoxazole, related to the disponibility and the accessibility of this drug.

Pneumocystosis is an opportunist parasitic disease which occurs currently at Europe and United States in HIV infected patients. In Africa, the disease is not current. Pneumocystosis has been detected in the Fann medical universitary center at Dakar from HIV infected patients with acido alcoholo resistant bacilli negative pneumopathy. Analysis of broncho alveolar liquid(BAL) of 29 patients after Giemsa and Blue of Toluidin O staining allowed isolating of two cases of pneumocystosis. A man and a woman were the patients. They were HIV1 positive with at X ray bilateral interstitial syndrome. The CD4 lymphocytes count of the one was lower than 200/mm3 and for the other it was higher than 200/mm3.