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Introduction: The objective of this study is to evaluate the factors favoring the detachment of bonded retainers after multi-band orthodontic treatment, Method: This was a descriptive retrospective study of 26 cases of retention detachments recorded in the dentofacial orthopedics department of the CHU-CNOS in Bamako over a period of 1 year from January 2, 2020 to December 31. 2020. The retainers were all bonded using the direct method using two types of composite. Two types of wires were used in patients. The data collection was made from the files of the patients followed in the service. Results: We counted 19 maxillary and 7 mandibular retainers. 19 retainers (73.1%) were bonded with fluid composite retainer and 7 retainers (26.9%) were bonded with normal restorative composite. The type of yarn used is solid yarn in 15 restraints and braided yarn was used in 11 restraints. There is less disbondment with the flowable bonding composite than with the dental restorative composition. Conclusion: The type of suture and the type of composite used seem to have an impact on the durability of the bonded retainer, without significant results.

The coronal-radicular reconstruction is a restoration that involves both the coronal part and the root part of the tooth. The objective of this study was to evaluate the clinical aspects of anterior teeth before performing corono-radicular reconstruction by inclay-core. This was a descriptive cross-sectional study for analytical purposes with prospective data collection at the fixed prosthesis department of the CHU-CNOS over a period of six (6) months from (June 2019 to December 2019). The study population was made up of patients who underwent corono-radicular reconstruction (CPR) on anterior teeth by inlay core in the fixed prosthesis department of the CHU-CNOS. The patients were submitted to a questionnaire relating to general information, the reason for consultation, the oral examination, the type of coronal-radicular reconstruction. In this study, the female sex was the most represented with 61.40% of cases and a sex ratio of 0.62 in favor of women. Dental caries was the most represented pathology, 47.14% of cases. Retro-alveolar radiography was done in the vast majority of patients, ie 91.42% of cases. Aesthetics was the most represented reason for consultation with 95.70% of cases. More than three quarters (80%) of coronal-radicular reconstructions by inlay-core on anterior teeth were performed in the maxilla. All the walls were dilapidated in more than three-quarters of the cases, i.e. 77.15%. Corono-radicular reconstruction was performed to serve as a bridge pillar in 58.30% of cases. In our study, the mechanical principles of reconstitution were good in 91.40% retention and 94.30% stabilization. Lift was also good at 54.3%. The quality of these principles depends on the clinical stage (preparation) and the technical design in the laboratory. This prosthetic element must meet several objectives, hence the need for multidisciplinary care. Efforts must be made at all levels for prosthetic rehabilitation, especially in anterior relief.

Plummer Vinson syndrome is a rare condition characterized by cervical dysphagia associated with iron deficiency anemia and a ring on the upper esophagus. Sometimes its unusual presentation can lead to misdiagnosis. We report the observation of a patient with Plummer-Vinson syndrome, revealed by upper dysphagia.

Introduction : La santé bucco-dentaire est caractérisée par l'absence de douleur buccale ou faciale, de cancer de la bouche ou du pharynx, d'infection ou de lésion buccale, de maladie parodontale, de déchaussement et de perte de dents et d'autres maladies et troubles qui limitent la capacité de mordre, mâcher, sourire et parler d'une personne, et donc son bien-être psychosocial. L'édentement étant un manque partiel ou total de dents, il réduit à lui seul la capacité de mordre, de mâcher, de sourire, de parler et de bien-être psychosocial. L'objectif général de cette étude était d'identifier les besoins de réhabilitation prothétique dentaire chez les patients hospitalisés âgés de 15 ans et plus dans le service d'hépato-gastro-entérologie du CHU Gabriel Touré de Bamako. Matériel et Méthodes : Il s'agissait d'une étude transversale descriptive qui s'est déroulée sur une période de 3 mois du 18 août au 18 novembre 2016 dans le service d'hospitalisation de l'unité d'hépato-gastro-entérologie du CHU Gabriel Touré de Bamako. Ont été inclus, tous les patients hospitalisés au service d'hépato-gastro- entérologie du CHU-Gabriel Touré, âgés de 15 ans ou plus ayant répondu aux questionnaires. Nous avons colligé 100 patients. Résultats : Dans notre étude, nous avons une prédominance masculine avec 58%. La tranche d'âge des 45 à 54 ans représentait 25% de la population active avec une moyenne de 44 ans. La présence de tartre est observée chez 70% de nos patients; la candidose était plus représentée avec 57% des cas. Sur le plan hépato- gastro-entérologique, les maladies hépatiques étaient les plus représentés avec 37%. L'étude a rapporté 64% des cas d'édentement avec au moins une dent manquante. La région molaire était la plus représentée dans 82,81% des cas. Conclusion : Les édentements constituent un problème de santé publique en raison de leur prévalence et de leur handicap. La réhabilitation prothétique dentaire rétablit l'équilibre biologique, fonctionnel, esthétique et psychologique.Mots clés : bilan, besoins, prothèse dentaire, hépato-gastro-entérologie, CHU-Gabriel Touré, Bamako

In Mali, the Malarial-5 which is an improved traditional medicine (ITM) made partly with the leaves of Lippia chevalieri is used to treat symptoms of uncomplicated malaria. One of the issues related to the production of this ITM is the quality of the raw material. The present work aimed to control the quality of the leaves from cultivated plants of L. chevalieri. This study was carried out from 2015 to 2016 in Mali. The morphology of the stem, leaves and the flowers of the cultivated plants was determined through their description. In addition, organoleptic and microscopical features of the leaves’ powder were examined. The findings revealed the presence of some macroscopic elements, organoleptic features and microscopic characters needful for the botanical control of L. chevalieri. Key words: Lippia chevalieri Moldenke, botanical quality control, improved traditional medicine, Mali.

Umbilical endometriosis, also called Villar’s nodule, has rarely been described in the literature. It represents only 0.5% to 1% of all cases of endometriosis. We report a case in a 28-year-old nulligest, nulliparous woman who consulted at the CSREF CII in Bamako. The diagnosis was suspected with the presence of umbilical swelling with cyclic, painful, dark hemorrhage of firm consistency. We performed an omphalectomy with an uncomplicated postoperative course. She was released from the hospital three days post-surgery. Anatomo-pathological examination of the resected specimen confirmed the diagnosis of umbilical endometriosis.

The diverticulum of the female urethra or sub-urethral pouch is in the form of a cul-de-sac lined with mucous membrane through the muscular layer of the urethra. Thus, it is a site of stasis, urinary infection, formation of calculus or even malignant tumor. The diverticula of the urethra or sub-urethral pouches in women have a prevalence of 0.5% to 6% depending on the series. We report the case of a 61-year-old patient operated for a diverticulum on fistulized urethra complicated lithiasis. Our patient had five pregnancies and five births when she consulted for dysuria, urinary burns evolving since a year. The urogenital examination revealed a partially stenotic urethral meatus and a 3-cm large fistulized intravaginal peri-urethral mass allowing urine leak. The mass was painful and hard at palpation. We performed transvaginal diverticulectomy. The follow-up was simple and the probe was removed two weeks after the surgery. An atomo-pathological examination of the resected diverticulum concluded an aspect compatible with lithiasis urethritis.

Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-alpha and/or IFN-omega are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-alpha and/or IFN-omega (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-beta. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-alpha and/or IFN-omega are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-beta do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases.

Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-α and/or IFN-ω are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-α and/or IFN-ω (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-β. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-α and/or IFN-ω are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-β do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases. © 2021 The Authors, some rights reserved.

Mosquito control remains a central pillar of efforts to reduce malaria burden in sub-Saharan Africa. However, insecticide resistance is entrenched in malaria vector populations, and countries with a high malaria burden face a daunting challenge to sustain malaria control with a limited set of surveillance and intervention tools. Here we report on the second phase of a project to build an open resource of high-quality data on genome variation among natural populations of the major African malaria vector species Anopheles gambiae and Anopheles coluzzii. We analyzed whole genomes of 1142 individual mosquitoes sampled from the wild in 13 African countries, as well as a further 234 individuals comprising parents and progeny of 11 laboratory crosses. The data resource includes high-confidence single-nucleotide polymorphism (SNP) calls at 57 million variable sites, genome-wide copy number variation (CNV) calls, and haplotypes phased at biallelic SNPs. We use these data to analyze genetic population structure and characterize genetic diversity within and between populations. We illustrate the utility of these data by investigating species differences in isolation by distance, genetic variation within proposed gene drive target sequences, and patterns of resistance to pyrethroid insecticides. This data resource provides a foundation for developing new operational systems for molecular surveillance and for accelerating research and development of new vector control tools. It also provides a unique resource for the study of population genomics and evolutionary biology in eukaryotic species with high levels of genetic diversity under strong anthropogenic evolutionary pressures.

Offianan Andre Toure,1 Tiacoh N’Guessan Landry,1 Serge Brice Assi,2,3 Antoinette Amany Kone,1Eric Adji Gbessi,1Berenger Aristide Ako,1 Baba Coulibaly,1 Bouakary Kone,4 Oumar Ouattara,4 Sylvain Beourou,1 Alphonsine Koffi,2 Franck Remoue,2,5 Christophe Rogier6 1Malariology Unit, Pasteur Institute of Côte d’Ivoire, Abidjan, Côte d’Ivoire; 2Malaria and Anopheles Research and Management Unit, Pierre Richet Institute, Bouake, Côte d’Ivoire; 3National Malaria Control Program, Bouake, Côte d’Ivoire; 4Department of Medicine, Health Care Center of Dar-Es-Salam, Bouake, Côte d’Ivoire; 5UMR 224-MIVEGEC, Research Development Institute, Montpellier, France; 6Army Health Department, Paris, France Introduction: Parasite clearance is useful to detect artemisinin resistance. The aim of this study was to investigate parasite clearance in patients treated with artesunate + amodiaquine (AS + AQ) and artemether + lumefantrine (AL): the two artemisinin-based combination therapies (ACTs) recommended in the first-line treatment of uncomplicated malaria in Côte d’Ivoire.Methods: This study was conducted in Bouaké, Côte d’Ivoire, from April to June 2016. Patients aged at least 6 months with uncomplicated malaria and treated with AS + AQ or AL were hospitalized for 3 days, and follow-up assessments were performed on days 3, 7, 14, 21, 28, 35, and 42. Blood smears were collected at the time of screening, pre-dose, and 6-hour intervals following the first dose of administration until two consecutive negative smears were recorded, thereafter at day 3 and follow-up visits. Parasite clearance was determined using the Worldwide Antimalarial Resistance Network’s parasite clearance estimator. The primary end points were parasite clearance rate and time.Results: A total of 120 patients (57 in the AS + AQ group and 63 in the AL group) were randomized among 298 patients screened. The median parasite clearance time was 30 hours (IQR, 24–36 hours), for each ACT. The median parasite clearance rate had a slope half-life of 2.36 hours (IQR, 1.85–2.88 hours) and 2.23 hours (IQR, 1.74–2.63 hours) for AS + AQ and AL, respectively. The polymerase chain reaction-corrected adequate clinical and parasitological response was 100% and 98.07% at day 42 for AS + AQ and AL, respectively.Conclusion: Patients treated with AS + AQ and AL had cleared parasites rapidly. ACTs are still efficacious in Bouaké, Côte d’Ivoire, but continued efficacy monitoring of ACTs is needed. Keywords: Plasmodium falciparum, ACTs, parasite clearance, Côte d’Ivoire

Objectif : L’objectif de notre étude était d’évaluer l’évolution des connaissances et attitudes pratiques des pharmaciens d’officine dans la lutte contre le paludisme en vue d’une implication des pharmaciens d’officines dans la lutte contre le paludisme. Méthodes : Il s’agissait d’une étude transversale descriptive qui s’est déroulée en deux phases dans les officines privées du district de Bamako, Mali. La première phase de l’étude (enquête initiale) s’est déroulée du mois d’avril à mai 2014, elle a porté sur 55 pharmaciens de la commune III et VI de Bamako. La seconde phase (monitorage) s’est déroulée de novembre 2014 à novembre 2015, après une formation de l’ensemble des pharmaciens d’officine du district de Bamako conformément aux directives du PNLP, qui avait concerné tous les pharmaciens du district de Bamako. Résultats : Cette étude a révélé que certains indicateurs se sont améliorés de manière significative: possession d’un document de la politique nationale ; connaissance des médicaments recommandés pour le paludisme simple ; pratique et vente des tests de diagnostic rapide du paludisme. D’autres indicateurs ont connu une progression: disponibilité des CTA; vente de moustiquaires imprégnées d’insecticide; comportement devant une suspicion de paludisme simple ; comportement devant une suspicion de paludisme grave. Conclusion : Ainsi, une implication des pharmaciens d’officines dans la surveillance épidémiologique palustre pourra diminuer de façon considérable le taux de morbidité et de mortalité liés au paludisme. Nous recommandons aux pharmaciens d’officine la dispensation des antipaludiques conformément aux recommandations du programme national de lutte contre le paludisme.

En 7 ans, nous avons colligé 100 cas de volvulus du colon sigmoïde à l’hôpital Sominé Dolo de Mopti. L’anse volvulée a été trouvée sans nécrose dans 66 cas et nécrosée dans 34 cas. Soixante-seize patients ont été l’objet d'une sigmoïdectomie suivie d'une anastomose colorectale en un temps, et vingt-et-un patients d’une intervention de Hartmann. Une détorsion chirurgicale a été réalisée chez 3 patients. Tous les patients opérés par ces deux dernières techniques ont eu un rétablissement de la continuité digestive dans un délai moyen de 90 jours. Les complications postopératoires ont été représentées par 11 cas de suppuration pariétale et un cas d’éviscération. La durée moyenne de suivi a été de 210 jours. Le taux de mortalité postopératoire a été de 14%. Il s'agissait d'un choc septique avec défaillance multi viscérale (n=13), et d'une embolie pulmonaire (n=1). Le traitement du volvulus est une urgence diagnostique et thérapeutique. Dans notre milieu, il repose sur la résection du sigmoïde en urgence suivie d’une anastomose immédiate si les conditions suivantes sont accomplies: état général bon, chirurgien expérimenté et réanimation pré, per et postopératoire possible.Mots clés: volvulus, colon sigmoïde, prise en charge, Mopti-MaliEnglish AbstractIn seven years, we have compiled 100 cases (66 with necrosis and 34 without necrosis) of sigmoid colon volvulus at the regional hospital Sominé Dolo in Mopti, Mali. Treatment consisted of a colorectal anastomosis in 76 patients and Hartmann intervention in 21 patients. Three patients had digestive untwisting. Digestive continuity was re-established at 90 days post surgery on average regardless of the technique of surgery. The average duration of follow up was 210 days. Post surgery complications consisted of 11 parietal suppurations and one evisceration with mortality rate of 14% (13 cases of heart failure with septic choc and one case of pulmonary emboli). Treatment of volvulus requires a quick diagnostic and therapeutic approach. The best treatment is the emergency resection of the sigmoid followed immediate anastomosis in the appropriate conditions (a good general condition, an experienced surgeon, adequate pre-, per- and post-surgery reanimation).Keywords: volvulus, sigmoid colon, management, Mopti

Ce travail a pour objectif d’évaluer les résultats de l’embrochage centromédullaire élastique stable (ECMES) dans les fractures diaphysaires du fémur chez l’enfant. Il s’agissait d’une étude prospective qui s’est déroulée de Janvier 2013 à Décembre 2013 dans le service de Chirurgie Pédiatrique du CHU Gabriel TOURE portant sur tous les enfants âgés de 7 à 15ans et présentant une fracture diaphysaire du fémur et dont le délai de consultation n’excédait pas 21 jours. En guise de résultat, nous avons opéré 15 cas de fracture diaphysaire du fémur soit 5% des fractures opérées (300 cas). L’effectif était composé de 8 filles contre 7 garçons soit un sexe ratio de 0,88. L’âge moyen de nos patients était de 10,1 ans avec des extrêmes de 7 et 14 ans. L’étiologie la plus fréquente était les accidents de la voie publique (73,3%). Le choc était direct dans 86,6%. Le fémur droit était atteint dans 53%. Le délai moyen de consultation était de 6 heures. Le trait de fracture était transverse dans 80% et oblique dans 20%. Le siège le plus fréquent était le 1/3 moyen de la diaphyse fémorale. Le délai moyen de prise en charge était de 3 jours.Nous avons procédé à un embrochage centromédullaire élastique stable ascendant dans 86,6%. Les résultats ont été évalués avec un recul moyen de 5 mois, ils étaient excellents dans 93,3% et un seul cas de raideur en extension de 10 degrés. En conclusion, l’ECMES est une technique particulièrement adaptée au traitement chirurgical des fractures diaphysaires du fémur de l’enfant d’âge scolaire. Bien pratiqué, il donne de bons résultats. Le traitement orthopédique doit rester de règle mais ceci n’est plus aussi formel qu’avant.Mots clés: fracture, diaphyse fémorale, grand enfant, ECMESEnglish AbstractThe objective of this work is to evaluate the results of stable elastic centro medullary insertion (ECMES) in diaphyseal femoral fractures in children. This was a prospective study that took place from January 2013 to December 2013 in the Department of Pediatric Surgery of CHU Gabriel TOURE, covering all children aged 7 to 15 years and presenting a diaphyseal fracture of the femur and whose consultation period did not exceed 21 days. We performed 15 cases of diaphyseal fracture of the femur or 5% of the fractures performed (300 cases). The number was 8 girls versus 7 boys, a sex ratio of 0.88. The average age of our patients was 10.1 years with extremes of 7 and 14 years. The most frequent etiology was road traffic accidents (73.3%). The shock was direct in 86.6%. The right femur was reached in 53%. The average time to consult was 6 hours. The fracture line was transverse in 80% and oblique in 20%. The most frequent seat was the middle 1/3 of the femoral diaphysis. The average waiting time was 3 days. We performed a stable elastic centro medullary insertion in 86.6%. The results were evaluated with an average follow-up of 5 months, excellent in 93.3% and a single case of stiffness in extension of 10 degrees. To conclude, stable elastic centro medullary insertion is a technique particularly adapted to the surgical treatment of diaphyseal fractures of the femur of the school-aged child. Well done, it gives good results. Orthopedic treatment must remain the rule, but this is no longer as formal as before.Keywords: fracture, femoral diaphysis, large child, ECMES