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The use of colloidal particles to prepare and stabilize emulsions, known as "Pickering emulsions “, has aroused growing interest in recent years. Pickering and Ramsden demonstrated at the beginning of the last century the feasibility of surfactant-free emulsions, in presence of these emulsions is called "Pickering Emulsions". This concept of emulsions stabilized by solid particles is experiencing renewed interest nowadays given the many advantages it offers good stability, environmental protection, user safety, and particle varieties. The first part is devoted to the synthesis of Eudragit RSPO and pol epsilon-caprolactone nanoparticles and their characterization. The characterization of the nanoparticles is performed by dynamic light scattering and geometry. The understanding of the interfacial behavior of these nanoparticles and their associated stabilization mechanisms for emulsions was carried out. The second part of the study investigated the formulation and stabilization of the emulsion using the washed suspension containing the nanoparticles as the only stabilizer. The objective of this part is to stabilize and characterize the formulated emulsions. Droplet size determination and microscopy were performed using a Zeiss optical microscope. The direction of the formulated emulsions was determined by conductimetry. In conclusion, Pickering emulsions stabilized solely by Eudragit RSPO and Poly-epsilon Caprolactone nanoparticles appear to be highly effective innovative drug carriers, opening new doors as potential drug delivery systems.

This study investigates the formulation of surfactant-free Pickering emulsions that release a drug at a specific pH to improve its oral bioavailability. The stabilizing particles composed of magnesium carbonate particles. Pickering oil-in-water emulsions stabilized with magnesium carbonate particles and encapsulating a hydrophobic drug model (ibuprofen) were formulated using a high-energy process with rotor-stator turbo mixer (IKA® T25 digital ultra-Turrax). The experimental approach explored the impact of all formulation parameters, dispersed phase and amount of magnesium carbonate particles on the physicochemical properties of Pickering emulsions. The O/W Pickering emulsion was characterized by a methylene blue test, pH and conductivity measurements, and droplet size determination. In addition, Pickering emulsions stabilized by magnesium carbonate particles have the advantage of being destabilized in acidic medium leading to the release of the active principle via the droplets. The acidic medium release study (pH equal to 1.2) showed ibuprofen release as a function of initial droplet loading and saturation concentration. In the simulated intestinal medium at pH equal to 6.8, we found a better release of ibuprofen from emulsions that already had saturation in an acid medium. Thus, the interest of these Pickering emulsions lies on the fact that their non-toxicity and magnesium carbonate particles allow destabilization of the emulsions and release of the drug. These emulsions not only protect patients from the side effects of acid-based drugs, but also contribute to increase the bioavailability of these acidic drugs. Keywords: emulsion -Pickering-magnesium carbonate- ibuprofen-oral bioavailability

Aim: We aimed to present a rare case of pseudotumoral tuberculosis of the cervix. Introduction: Tuberculosis has many localizations. Urogenital and particularly cervical involvement is rare. Case Presentation: Our observation concerned a case of pseudotumoral tuberculosis of the uterine cervix simulating a cancer. The clinical signs were pelvic pain and metrorrhagia, which were non-specific. The ulcerative-bourgeons appearance of the cervix was suggestive of cancer. Histology allowed the diagnosis to be made by showing an inflammatory granuloma and the absence of malignant cells. Despite the absence of bacteriological evidence, the clinical, biological, and histological presumptive arguments and the good therapeutic response made it possible to correct the diagnosis. The prognosis of our patient was mainly functional due to the risk of infertility. Conclusion: The interest of this observation lay in the rarity of this tuberculosis localization, especially in an immunocompetent subject, and the predominant place of histology.

Les rhumatismes inflammatoires chroniques sont une cause importante d'invalidité dans le monde entier. De ce fait, les affections rhumatismales chroniques font peser une lourde charge sociale et économique sur toutes les sociétés, pas seulement sur celles où l’espérance de vie est élevée. L’objectif principal de ce travail était d’étudier le profil de libération pH-dépendante de principes actifs hydrophobes à partir d’oléogels oraux et/ou cutanés. La formulation des oléogels a été réalisée selon une méthode sol-gel, reproductible à grande échelle. La caractérisation et le suivi dans le temps ont montré une bonne stabilité des oléogels. Les valeurs de pH des oléogels étaient globalement acides (entre 4,3 et 5,8) et dépendaient de la quantité de gélifiant utilisée. Les études de libération du kétoprofène, principe actif hydrophobe, en fonction du pH des milieux de dissolution ont montré des profils de libération d’une cinétique du premier ordre d’équation 𝑷𝒕=𝑷𝟎+𝑨.𝒆𝒙𝒑𝑲𝒕 avec des coefficients de détermination proches de 1 (milieux à pH égal à 1,2 et 5,5). Une meilleure libération du kétoprofène a été obtenue dans un milieu intestinal simulé (pH égal à 6,8) pour les formulations qui présentaient déjà une saturation en milieu gastrique simulé (pH égal à 1,2). Cette étude qui a permis de formuler, d’évaluer et de modéliser le profil de libération du kétoprofène à partir d’oléogels peut constituer une étape importante dans un objectif de souveraineté thérapeutique des pays d’Afrique subsaharienne notamment le Sénégal.Mots clés : Oléogels, rhumatismes inflammatoires chroniques, kétoprofène, libération contrôlée, pH-dépendant. English Title: pH-dependent controlled release systems of hydrophobic active pharmaceutical ingredients from oleogels Chronic inflammatory rheumatism is a major cause of disability around the world. As a result, chronic rheumatic diseases place a heavy social and economic burden on all societies, not just those with high life expectancy. The main objective of this work was to control the pH-dependent release of hydrophobic active pharmaceutical ingredients from oral and / or skin oleogels. The formulation of the oleogels was carried out using a sol-gel large-scale reproducible method. Characterization and monitoring over time have shown good stability of the oleogels. The pH values of the oleogels were overall acid (between 4.3 and 5.8) and depended on the amount of gelling agent used. The release studies of ketoprofen, a hydrophobic active pharmaceutical ingredient, as a function of the pH of the dissolution media have shown release profiles of first-order kinetics of equation 𝑷𝒕=𝑷𝟎+𝑨.𝒆𝒙𝒑𝑲𝒕 with coefficients of determination close to 1 (media at pH equal to 1.2 and 5.5). Better release of ketoprofen was obtained in simulated intestinal medium (pH equal to 6.8) for formulations which already exhibited saturation in simulated gastric medium (pH equal to 1.2). This study, which made it possible to formulate, evaluate and model the release profile of ketoprofen from oleogels, may constitute an important step in an objective of therapeutic sovereignty of the countries of sub-Saharan Africa, particularly Senegal.Keywords: oleogels - chronic inflammatory rheumatism - ketoprofen - controlled release – pH-dependent.

Nanomedicine has been a booming industry with the development of nanovectors to encapsulate water-soluble or amphiphilic molecules for drug delivery. As the new therapeutic agents synthesized are increasingly lipophilic, the development of new nanoparticulate vectors allowing their transport and targeting is now a major challenge. These particles are lipid nanoparticles, a few hundred nanometers in diameter, stabilized by a layer of surfactants composed of castor oil and stealth agents. Solid lipid nanoparticles based on shea butter, stabilized by cremophor® ELP, encapsulating griseofulvin, were formulated by the temperature phase inversion method. The shea butter nanoparticles thus obtained were the subject of characterization relating to: determination of the morphology, size, polydispersity index, pH and zeta potential. The results confirm the stability of our preparations. The anti-inflammatory activity of shea butter being known, the tests were carried out on mice. The inflammation was induced by a solution of croton oil acetone. There is a very big improvement in anti-inflammatory activity. This is due to better penetration of the preparation through the different layers of the skin. Griseofulvin release studies have been carried out on our various preparations. Systems designed as reservoirs of active ingredients and intended for a priori controlled release obey kinetics of the order of one-half (½) corresponding to a proportionality between the quantity released and the square root of time. Shea butter in nanoparticulate forms has thus enabled us to considerably prolong the release of griseofulvin. Keywords: Nanoparticles; Shea Butter; Inflammation; Griseofulvin.

Graves’ disease and Hashimoto’s thyroiditis are two common autoimmune diseases. Their association with other autoimmune diseases is not exceptional. However, the co-occurrence of these two diseases is not often described. In this case, report, we describe the observation of a patient who had long been followed for exophthalmos and pretibial myxedema as a sign of thyrotoxicosis. Examination of this patient revealed a clinical picture of clinical and biological hypothyroidism related to Hashimoto’s thyroiditis. This case had made it possible to retain an association between Hashimoto’s thyroiditis and basedowdisease, which is rarely described. This observation underscores the importance of monitoring these patients with autoimmune disease systematically even if there is no clinical manifestation.

Introduction: Autoimmune thyroiditis is relatively common in medicine. However, comprehensive studies are few in number, especially in Africa and particularly in Senegal. The aim of this study was therefore to determine the epidemiological, clinical, profile of Autoimmune Thyroid Diseases (OITD). Materials and Methods: This was a retrospective descriptive study from 2016 to 2019 of the records of patients who consulted or were hospitalised for autoimmune dysthyroidism in the internal medicine department of the Aristide Le Dantec Hospital. During this period, 1227 new consultations were recorded; they concerned three specialized consultations including endocrinology. The autoimmune origin was confirmed in 159 patients, i.e. in 45.69% of cases the AIDM then 12.96% of all consultations. The autoimmune origin was established on clinical, biological and immunological grounds. The data were collected from the medical records of the patients and recorded on a pre-established individual survey sheet taking into account the objectives of the study. The data collected was entered into the Sphinx V5 software on an established form. The analysis was carried out with the following software: Excel 2010 and Epi info 7.2. Results: Among this dysthyroidism, 159 patients had a confirmed autoimmune thyroid disease. On all new consultations, OITD represented 12.96% of internal medicine consultations. The sex ratio M/F was 0.18. The majority of our patients (57.86%) were aged between 25 and 44 years with extremes ranging from 11 to 63 years. In Graves’ disease, the notion of an irritative spine was found in 60.27% of cases. Signs of thyrotoxicosis were present in 92.7% of cases. There was a goiter in 81.1% of cases with a vascular character in 76.47% of cases. Anti-THR antibodies were positive in 96.15% of cases. Complications were noted in 9 patients (6.5%) such as cardiothyreosis in 8 patients (5.7%) and malignant orbitopathy noted in 1 patient (0.8%). In Hashimoto’s thyroiditis, signs of hypometabolism were evident in 87.50% of patients. Anti-TPO antibodies were positive in all patients. All patients had received thyroid hormone supplementation. Thyroid autoimmune disease was associated with other autoimmune diseases in 6.2% of cases. Conclusion: Autoimmune thyroiditis is common in our daily practice in Senegal; it is dominated by Grave’s disease. Hypothyroidism was the most common manifestation of Hashimoto’s thyroiditis. The inaccessibility of antithyroid antibody testing is an obstacle to the diagnosis and management of these conditions.

Introduction: Venous thromboembolic disease (VTE) is a real public health problem worldwide. The practice guide produced periodically by the American College of Chest Physicians (ACCP) has become the international standard. However, thromboprophylaxis remains underused. Methodology: We carried out a descriptive cross-sectional study. The goals of that study were to evaluate the effectiveness of the practice of thromboprophylaxis in the various medical services of the Dakar Public Hospitals. Our investigation was conducted for two weeks in September 2017. Results: 160 patients were included (81 men and 79 women) in our series, with male predominance: sex ratio of 1.02. The average age was 48. Infectious pathologies were the predominant clinical pictures (35% of cases). The thromboembolic risk factors (RF) mainly found were represented by prolonged bed rest, followed by cardiovascular (RF): age greater than 60 years (31.2%), hypertension (8.8%), obesity (4.4%) and diabetes (3.8%). The thromboembolic RF of patients hospitalized in these medical services has been evaluated empirically. We noted a lack of use of the VTE risk assessment scores. 40.9% (n = 56) of patients received overall VTE prophylaxis, a rate corresponding to almost half of those at risk (51.4%). This result reflects an under-use of thromboprophylaxis in the Dakar medical environment and a low level of adherence by practicians to the guidelines on VTE prophylaxis. Conclusion: It is therefore recommended to develop a national strategy to assess patients at risk for VTE, as well as measures to educate and inform doctors about the appropriate forms of thromboprophylaxis.

Introduction: The occurrence of tuberculosis (TB) during the follow-up of Connective tissue diseases (CTD) is a particular situation often posing real diagnostic problems. This is an association described in the literature. Patients and methods: We conducted a retrospective and descriptive study at the internal medicine department of Aristide Le Dantec Hospital. The purpose of this study was to determine the treatment that patients followed for CTD and suffering from TB took before the occurrence of this one. Results: During a study period of 11 years and 6 months, 21 cases of TB were diagnosed in 602 cases of CTD (0.03%). The predominance was female with a sex ratio (H/F) of 0.6. The median age was 42 years old. The majority of cases originated from the Dakar region (13 patients or 61.9%) and 85.7% had previous follow-up exclusively in modern medicine and 21 cases (95%) received the CTD’s treatment. This consisted of prednisone (90.5%) combined with methotrexate (52.4%), azathioprine (23.8%) or cyclophosphamide (19.4%). The respective medians doses of these drugs were 12.5 mg per day for prednisone, 13.5 mg per week for methotrexate and 100 mg per day for azathioprine. The median duration of patient follow-up was 36 months. The cumulative dose of prednisone during this period was 23.6 g and that of methotrexate 2.25 g. CTD were dominated by rheumatoid arthritis (RA) (57.1%), and systemic lupus (19%). Isolated cases of systemic scleroderma, primary Sjogren, SHARP syndrom, mixed connective tissue disease, and multiple autoimmune syndrom were noted. TB was localized in 95% of cases, readily bilateral and poorly disseminated. The respective medians diagnostic delays for systemic disease and TB were 21 months and 5 months. Tuberculin intradermal reaction was performed in 16 cases and was positive in 9 cases, sputum bacilli was performed in 19 cases and was positive in 15 cases. Conclusion: The association of TB and CTD was characterized by its rarity, its poorly disseminated character and its frequency on RA field.

Multiple emulsions are of great therapeutic interest especially in the administration of medicines which can be inactivated by digestive enzymes; moreover the researches of formulation not being often easy, a control of the different phases physicochemical parameters would be of great interest in rapid formulations and at low cost. When formulating emulsions, the preliminary tests, also known as formulation tests, constitute a step which can be long and expensive because of the quantity of reagents that can be used. A rigorous methodology could thus be of great interest, which is at the aim of our study which consists of evaluating the physico-chemical parameters of different phases used to make thus multiple emulsions. In our study, physico-chemical parameters such as conductivity, pH, density, viscosity, and surface tension have been studied by direct measurement using equipment and also by means of suitable mounting. The results showed that the pH and the surface tension have an important role in the prediction of the stability of emulsions, these latter must be of the same order of magnitude. For all phases conductivity does not have too much interest apart from helping to determine the type of the emulsion.

Introduction: The extended administration of corticoids by oral way for a length of more than 3 months defines the long-term-corticosteroid-therapy. This one, used in numerous indications, displays most often at the risk of undesirable effects linked sometimes to the habits of prescription of the doctors. Patients and Methods: In order to study the prescription modalities of this treatment, we conducted a cross-sectional, multicentric and descriptive study from June 1st, 2017 to August 1st, 2017, over a period of 2 months. It involved a questionnaire given to medical specialists of all medical specialties and practicing in the University Hospital of Dakar. Results: 170 doctors were interviewed. Dermatologists and internists were mostly found 19.4% and 18.8% or 33% and 34% doctors. Systemic autoimmune diseases alone accounted for 48% of prescription reasons. Prednisone was prescribed in 88% of cases. The immunosuppressive dose of 1 mg/kg was most often prescribed. Practitioners very heterogeneously prescribe most adjuvant measures to prolonged systemic corticosteroid therapy. Thus, the recommendation of a low-sodium diet (38% of physicians), and the systematic prescriptions of proton pump inhibitors (44.7% of physicians) and vitamin-calcium supplementation were frequently performed by physicians (34% of physicians). While the low carbohydrate diet was advocated by less than a quarter of doctors and the prevention of pneumocystosis and osteoporosis were rare (respectively 61% and 52% of prescribers did not). Conclusion: The global analysis of the habits of our medical specialists concerning the use of long-term glucocorticoids reflected a diversity of indications, heterogeneity of practices, with certain habits not in accordance with the usual recommendations.

Background: The morbidity and mortality of systemic lupus erythematosus are largely due to accelerated atherosclerosis. This is partly related to the high prevalence of traditional cardiovascular risk factors. The aim of our study was to determine the frequency of these factors in lupus patients compared to a control population in a department of internal medicine. Methods: We realized a case-control study in patients with systemic lupus erythematosus according to ACR criteria in 1997. Patients were matched by age and gender with controls subjects without autoimmune disease. We studied the frequency of traditional cardiovascular risk factors in both populations. The study was done in the department of internal medicine of Aristide Le Dantec teaching Hospital, in Senegal, during the period from August 2017 to December 2018. The statistical analysis was performed with SPSS 23.0 software and the level of significance was retained for a p-value < 0.05. Results: We recruited 100 subjects including 50 patients and 50 controls. The mean age was 33.5 ± 11.3 years in cases and 33.3 ± 11.3 years in controls. Dyslipidemia was significantly associated with systemic lupus erythematosus (p = 0.009). Levels of triglycerides (p < 0.001) and uricemia (p < 0.001) were significantly higher in patients. The level of HDL cholesterol (p = 0.028) was lower in cases. Thus, low HDL cholesterolemia (p = 0.001), hypertriglyceridemia (p < 0.001), and hyperuricemia (p = 0.043) were more common in the cases. Renal failure was associated with systemic lupus erythematosus (p < 0.001). Difference in LDL-cholesterol (p = 0.103), hypertension (p = 1) and metabolic syndrome (p = 1) between cases and controls was not significant. Obesity and overweight were predominant in controls (p = 0.028). Conclusion: Traditional cardiovascular risk factors including dyslipidemia and hyperuricemia were more common in patients. Similarly, renal failure was associated with lupus.

Introduction. Le processus d’initiation de l’arthrose relève de plusieurs facteurs parmi lesquels l’obésité occupe une place importante expliquant l’individualisation récente du concept d’arthrose métabolique. Nos objectifs étaient d’évaluer le statut pondéral des patients arthrosiques en milieu de Médecine Interne au Sénégal et d’analyser les éventuelles comorbidités associées à l’arthrose. Patients et méthodes : Une étude transversale et descriptive, de juin 2016 à février 2017, a inclus les patients suivis pour une arthrose primitive quel qu’en soit la localisation aux services de Médecine Interne de l’Hôpital Aristide Le Dantec et de l’Hôpital Principal de Dakar. Les données sociodémographiques, les aspects de l’arthrose, les mesures anthropométriques et les comorbidités ont été recueillis et analysés à l’aide du logiciel Sphinx Plus2 Excel. Résultats : Cent quatorze patients ont été inclus ; leur âge moyen était de 60,16 ans (extrêmes de 39 et de 94 ans) avec un sex-ratio de 0,16 (98 femmes). La localisation de l’arthrose était le genou (71,9 %), le rachis (50 %), l’épaule (5 %), la hanche (4 %), les pieds (3 %) et les mains (3 %). L’IMC moyen était de 28,97 Kg/m2 avec 30,7 % des patients en surpoids et 33,1 % en obésité. L’obésité était notée chez 47 % des patients atteints de gonarthrose et 35,5 % de lombarthrose. L’obésité abdominale concernait 64 % des femmes et 30 % des hommes. L’hypertension artérielle, le diabète et l’hypercholes-térolémie étaient observés respectivement chez 42, 10 et 6 % des patients. Conclusion : la surcharge pondérale, l’obésité et les autres facteurs de risque cardiovasculaires sont des situations fréquentes chez les patients arthrosiques vus dans les services de Médecine Interne au Sénégal. Ces constatations rappellent l’importance des mesures hygiéno-diététiques dans la prise en charge et la prévention de l’arthrose.

Background The association of macrophage activation syndrome and primary Sjögren’s syndrome has been rarely reported in the literature. We report the first observation of this association in Africa, south of the Sahara, and we discuss the diagnosis and therapeutic challenge. Case presentation A 26-year-old Mauritanian and Berber woman was followed for primary Sjögren’s syndrome. After a voluntary cessation of her usual background treatment, she was admitted to our department for an outbreak of her illness. A clinical examination revealed anemic syndrome, peripheral polyarthritis, coughing rales at both pulmonary bases, and fever at 39.5 °C. On biologic examination, there was bicytopenia with anemia at 5.70 g/dl, lymphopenia at 796/mm3, a biological inflammatory syndrome with a sedimentation rate at 137 mm in the first hour, C-reactive protein at 97 mg/l, hyperferritinemia at 1778 mg/l (9 normal value), and hypergammaglobulinemia at 20.7 g/l of polyclonal appearance. The triglycerides were 1.95 g/l (1.4 normal value) and the lactate dehydrogenase level was 491 IU/l (1.5 normal value). Cytological examination of a medullary puncture revealed an image of hemophagocytosis. An infectious screening was negative. Thoracic computed tomography showed non-specific interstitial lung disease. A diagnosis of macrophage activation syndrome complicating primary Sjögren’s syndrome was selected with a probability of 97.2%, according to H-Score. The evolution was favorable under a treatment including etoposide (VP-16). Conclusion Macrophage activation syndrome is a rare entity, rarely reported during primary Sjögren’s syndrome. Its spontaneous evolution is invariably fatal. There is no consensus on therapeutic treatment. Etoposide is a therapeutic option especially in forms refractory to corticosteroid therapy.

OBJECTIVE To determine the epidemiological and etiological profile of tinea capitis in adults in Dakar (Senegal). PATIENTS AND METHODS A 9-month prospective, multicenter, descriptive and analytic study. Patients included were aged over 18 years. Mycological tests were used to confirm the diagnosis. RESULTS 121 patients were included with a mean age of 36.1 years and a hospitalisation frequency of 0.8%. The age range of 64.4% of patients was between19 and 38 years. 51% of patients were housewives. A low socioeconomic level was found in 72.8% of cases. In 3.3% of patients, the disease began in childhood. 31.4% of patients had already consulted a traditional healer. Similar familial cases were noted in 60.3% of patients. Contact with a sheep was noted in 32.2% of cases, deliberate skin lightening in 64% of women, hair salon attendance in 46.7% of women, and immunosuppression in 17.3% of patients, while itching was present in 95.5%. Dermatologic examination showed scaled plaques and a diffuse form, with 92.6% and 64% (n=75) respectively. Wood's light examination was positive in 40.2% of patients. A positive culture test was found in 71%. The most frequently encountered species were: T. soudanense (65%), M. audouinii (21%), T. rubrum (4.7%), M. gypseum (3.5%), T. violaceum (2.3%), T. verrucosum (2.3%) and M. canis (1 case). The clinical course was favorable under treatment with griseofulvin or terbinafine. CONCLUSION Tinea capitis in adults mainly affects young women. The diffuse form is the most common. The most frequently encountered species was T. soudanense.

Introduction: The central, psychiatric and peripheral neurological manifestations of lupus are among the most severe visceral disorders and are grouped under the general term of “neuro-psychiatric systemic lupus erythematosus” (NPSLE). We conducted a cross-sectional observational study within our Department of Internal Medicine aimed at describing the clinical and evolutionary aspects of central neurological disorders of SLE, excluding lupus myelopathy. Patients and Methods: This was a retrospective and observational cross-sectional study carried out from 1 January 2015 to 31 October 2017, in the Department of Internal Medicine of Aristide le Dantec University Hospital in Dakar (Senegal). All patients hospitalized during this period who met the 1997 ACR classification criteria of SLE and who presented with a central neuropsychiatric syndrome attributable to SLE (as defined by ACR 1999) were included. Patients with isolated headache, acute myelitis or secondary neurological involvement attributable to a toxic, metabolic, infectious or tumour-related cause were excluded from our study. Results: During the study period, 10 patients with neuropsychiatric lupus involvement were treated at our institution, including 9 women and 1 man; the median age was 29 years (20 - 55 years). Neurological involvement occurred during the course of lupus evolution in 9/10 cases. The median time to SLE evolution was 18 months (0 - 60 months). Neuropsychiatric syndromes as defined by the 1999 ACR were commonly associated and more than half of our patients had multiple neuropsychiatric syndromes. There were 5 cases of confusion syndrome and coma, 4 cases of seizure, 3 cases of psychosis, 2 cases of acute cerebrovascular disease and 1 case of aseptic meningitis. Among the extra-neurological manifestations of SLE, haematological and dermatological involvements were common. Renal involvement affected half of the patients. The other manifestations were: polyarthritis in 3 patients, serositis in 2 patients, 5 cases of fever, 4 cases of deterioration of the general state, and one isolated case of ophthalmological involvement. Therapeutically, 8 patients received a bolus of methylprednisolone and 3 patients received a bolus of cyclophosphamide. Oral corticosteroids and hydroxychloroquine were administered to all patients, and azathioprine was administered in 2 patients. The evolution was favorable in 4 patients, other 2 patients maintained neurological sequelae and 2 patients were transferred to intensive care. Death was recorded in 4 patients. Conclusion: Neuropsychiatric manifestations of lupus are rare and sometimes severe, potentially life-threatening. In our patients, we have identified some of the most severe neurological syndromes according to the ACR nomenclature. The neurological involvement is exceptionally revealing, as these syndromes are often associated and integrated into a systemic context of lupus. The evolution is rapidly unfavorable and requires early diagnosis and optimal management.

La paralysie périodique hypokaliémique thyrotoxique est une complication rare de l'hyperthyroïdie. Plus souvent rapportée chez les sujets asiatiques, elle est peu décrite dans la population noire. Son mécanisme peu élucidé, serait lié à une hyper activité de la pompe Na+/K+. Nous présentons deux cas de cette affection survenant chez des sujets noirs africains. La présentation clinique était identique chez les deux malades. Elle était faite d´une paralysie musculaire proximal des membres inférieurs. Cette paralysie était associée à une hypokaliémie sévère et survenait chez des patientes suivies pour maladie de Basedow sans autre pathologie associée. L´évolution a été rapidement favorable sous supplémentation potassique. Le traitement de l´hyperthyroïdie a permis d´éviter les récidives. Ces observations montrent l´importance d´évoquer le diagnostic de paralysie périodique hypokaliémique thyrotoxique malgré la rareté dans la population noire africaine.

When formulating emulsions, the preliminary tests, also known as formulation tests, constitute a step which can be long and expensive because of the quantity of reagents that can be used. A rigorous methodology could thus be of great interest, that is at the aim of our study which consists of evaluating the physico-chemical parameters of different phases used to make thus multiple emulsions.In our study, physico chemical parameters such as conductivity, pH, density, viscosity, and surface tension have been studied by direct measurement using equipment and also by means of suitable mounting.The results showed that the pH and the surface tension have an important role in the prediction of the stability of emulsions, these latter must be of the same order of magnitude. For all phases conductivity does not have too much interest apart from helping to determine the type of the emulsion.STATEMENT OF SIGNIFICANCEMultiple emulsions are of great therapeutic interest especially in the administration of medicament which can be inactivated by digestive enzymes, moreover the researches of formulation not being often easy, a control of the physicochemical parameters of the different phases would be of great interest in rapid formulations and at low cost.

International audience; The purpose of this study was to develop Pickering water-in-oil nano-emulsions only stabilized by Eudragit RL100 nanoparticles (NPs), in order to increase the nano-emulsion stability and create a barrier to improve the drug encapsulation and better control the drug release. The first part of this study was dedicated to investigating the nano-emulsion formulation by ultrasonication and understanding the interfacial behavior and role of NPs in the stabilization of the water/oil interface. The focus was on the surface coverage in the function of the formulation parameters (volume fractions) to disclose the extents and limitations of the process. The main physicochemical analysis of the Pickering nano-emulsions was performed by dynamic light scattering and transmission electron microscopy. On the other hand, the second experimental approach was dedicated to understanding the interfacial behavior of the Eudragit RL100 NPs toward a model water/oil interface, using a dynamic tensiometer with axisymmetric drop shape analysis. The study investigated the NPs’ adsorption, as well as their rheological behavior. The aim of this part was to reveal the main phenomena that govern the interactions between NPs and the interface in order to understand the origin of Pickering nano-emulsions’ stability. The last part of the study was concerned with the stability and in vitro release of a model encapsulated drug (ketoprofen) in a gastric and simulated intestinal environment. The results showed that Pickering nano-emulsions significantly improved the resistance to gastric pH, inducing a significantly slower drug release compared to classical nano-emulsions’ stabilized surfactants. These Pickering nano-emulsions appear as a promising technology to modify the delivery of a therapeutic agent, in the function of the pH, and can be, for instance, applied to the oral drug delivery of poorly soluble drugs.

International audience; This study investigates the formulation of surfactant-free Pickering nano-emulsions able to release a drug at specific pH, in order to enhance its oral bioavailability. The stabilizing nanoparticles composed of magnesium hydroxide, were obtained by nano-precipitation method. The oil-in-water Pickering nano-emulsions stabilized with Mg(OH)2 nanoparticles, and encapsulating a model of hydrophobic drug (ibuprofen) were formulated following a high-energy process, using a sonication probe. The experimental approach explored the impact of all formulation parameters, composition and size of Mg(OH)2 nanoparticles, on the physico-chemical properties of the Pickering nano-emulsions. The system was characterized by DLS and transmission electron microscopy. In addition, Mg(OH)2 has the advantage of being solubilized in an acid medium leading to the destabilization of the nano-emulsion and the release of the active ingredient orally. The acid release study (pH = 1.2) showed cumulative release as a function of initial nanodroplet loading and saturation concentration. In basic media (pH = 6.8), we found a significant release of ibuprofen from the nano-emulsions that already had saturation in an acid medium. These nano-emulsions can not only protect patients from the side effects of acid medicines through the basic properties of hydroxides but also can contribute to the increase of the bioavailability of these drugs. In addition, once in the stomach pH is increased by hydroxides and promotes the release of active ingredients such as ibuprofen whose solubility is strongly influenced by pH.

Resume Objectif Decrire les etiologies, la presentation clinique et la prise en charge therapeutique du glaucome neovasculaire (GNV) chez les patients senegalais. Patients et methodes Nous avons realise une etude retrospective sur les dossiers des patients suivis pour GNV entre 1993 et 2016. Nous avons inclus les yeux presentant une rubeose irienne avec ou sans hypertonie oculaire. Pour chaque patient, nous avons releve l’âge, le sexe, les antecedents medicaux et ophtalmologiques, les donnees de l’examen ophtalmologique, les modalites therapeutiques reparties en hospitalisation, gestes therapeutiques et nombre d’hypotonisants prescrits. Nous avons utilise le logiciel epi-info 7 pour l’analyse des donnees. Resultats Quarante-huit yeux de 44 patients etaient atteints. L’âge moyen etait de 59,7 ans et le sexe ratio de 2,1. Les etiologies etaient le diabete de type II chez 31,8 % des patients et une occlusion de la veine centrale de la retine chez 16,6 % des yeux. La cecite touchait tous les yeux. La douleur oculaire etait presente chez 75 % des yeux, un cercle perikeratique chez 29,1 % des yeux, une mydriase areflexique chez 31,25 % des yeux. La pression intraoculaire moyenne etait 49,7 mmHg. Un œdeme corneen etait observe a 54,1 % des yeux. L’examen du fond d’œil montrait 14,5 % de retinopathie proliferante. Le traitement avait necessite une hospitalisation chez 43,75 % des patients. Les gestes therapeutiques realises etaient la cyclocryoapplication pour 31,25 % des yeux, l’injection retrobulbaire xylo-alcool pour 14,5 % des yeux et la photocoagulation panretinienne (PPR) au laser a 12,5 % des yeux. Les hypotonisants etaient utilises en bitherapie pour 29 % des yeux, en tritherapie et quadritherapie pour 25 % des yeux chacun. Discussion Les etiologies sont comparables aux donnees de la litterature. Le diagnostic etait tardif et les moyens therapeutiques limites par des conditions economiques defavorables. Conclusion Le GNV du patient senegalais est une affection de l’homme de la soixantaine. Il est responsable de cecite irreversible douloureuse au traitement difficile d’ou l’interet de sa prevention par une surveillance rigoureuse et un traitement energique de toute ischemie retinienne.

Pickering emulsions are systems without surfactants, stabilized by solid particles. These emulsions are experiencing a renewed interest, on the one hand, because it is preferable to limit the use of synthetic surfactants for toxicological and environmental reasons and, on the other hand, the need to make new formulations in order to control the drug release patterns by encapsulation or controlled release. Thus, we were interested in the formulation and evaluation of W / O Pickering emulsions stabilized by particles of magnesium oxide with tramadol hydrochloride in the internal phase. The Bancroft rule served as a model for the formulation. The emulsification was carried out by progressively adding an aqueous phase dispersed in an oil-dispersing phase using a turbo rotor stator mixer. The stability of these emulsions was studied using several parameters (droplet size, pH, viscosity, conductivity...) and the qualitative and quantitative analysis of the active ingredient by UV-visible spectrophotometry. The results obtained showed that the dye test and the conductivity measurement confirmed the W / O nature of these emulsions. Some parameters such as droplet size, pH and viscosity were strongly influenced by the amounts of Magnesium oxide particles and the active ingredient. The qualitative and quantitative analysis of the active ingredient confirmed the presence of tramadol in the internal aqueous phase. Thus, we have succeeded in developing a stable W / O Pickering emulsion with magnesium oxide particles. In addition, we were able to encapsulate tramadol in the dispersed aqueous phase.

Introduction: Systemic diseases have been the subject of few studies in the African literature and have probably been under-estimated. The objective of our study was to specify their spectrum, their epidemiological aspects and diagnostic delay in Internal Medicine Departments of Dakar (Senegal). Material and Method: It was a multicentric retrospective and descriptive study regarding all systemic diseases during 119 months from 1st January 2005 to 30 November 2014 in 5 hospital centers down Dakar. Systemic diseases were retained according to their international consensus criteria. Results: During the studying period, 726 patients were included with 632 women and 94 men (sex ratio of 0.14). The average age was 43.76 years. Inflammatory rheumatoid family history was noted in 10.06% of cases. Rheumatoid arthritis (RA) was the predominant affection, recorded on 564 patients, isolated or associated with other systemic diseases. It was followed in a decreasing order, in the systemic auto-immune diseases sub-groupe, by systemic lupus (56 cases), Sjogren’s syndrome (32 cases), Systemic Sclerosis (26 cases), Idiopathic inflammatory myopathies (21 cases), Undifferentiated connective tissue diseases (20 cases), Anti Phospholipid’s syndrome (6 cases) and Mixed connective tissue disease (6 cases). A diagnosis of systemic vasculitis was recorded in 19 patients. The other systemic affections were represented by systemic sarcoidosis (8 cases), Adult-onset Still’s disease (03 cases), amyloidosis (02 cases) and 02 cases of systemic syndrome associated to immunodeficiency. The mean diagnostic delay duration before the diagnostic was 3.46 years. Conclusion: Systemic diseases in internal medicine are characterized by their diversity, the clear predominance of RA, and significant diagnostic delay.

Introduction: The increase of both the frequency and severity of the bacterial dermohypodermitis (BDH) in Senegal suggests the existence of other risk factors outside of those classically known to be involved. Our study aimed to clarify the epidemiological, clinical and risk factors of BDH in Senegal.