Benefits and challenges of a community-based programme for women living with HIV in Mali

Gundo-So is a community-based programme developed by and for women living with HIV (WLHIV) in Mali through the ARCAD-Santé-PLUS association. It provides support, co-constructed with WLHIV, to develop strategies on whether or not to disclose their status. The aim of the ANRS-12373 research is to evaluate the impact of this programme in the short and medium term. As part of this research, semi-structured interviews were conducted with participants (14). These interviews were analysed thematically. Three themes are presented here: positive feedback from the programme, which enabled them to be listened to and supported them both psychologically and financially. The impact of the programme on the participants' social network is also described, in terms of the links made with peers met during the programme. Finally, a new perspective on issues such as disease management, which improved through the contribution of knowledge, and also through the development of psychosocial resources. The programme enabled participants to acquire psychosocial skills, the ability to effectively self-manage their condition, and strategies on whether or not to disclose their HIV status. Participants' empowerment and social support in relation to the disease were developed through the programme, particularly through the links created with other women living with HIV.

[Appendiceal Duplication In A Patient Operated For Chilled Appendix Breastplate At Gao Regional Hospital]

Appendiceal duplication is the very rare malformation. It was first described by Picoli in 1892. It is a condition that is most often seen in the first years of life, sometimes some forms may remain asymptomatic and only occur in adulthood. We report the case of appendiceal duplication in a patient operated for chilled appendix breastplate at Gao Regional Hospital.

CONCLUSION

appendiceal duplication is a rare abnormal abnormality of intraoperative discovery in general. Each surgeon must think about it during an appendectomy.

[Chronic kidney failure at subclinical stage in hypertensive patients in the cardiology department of the Gabriel TOURE university hospital]

OBJECTIVE

This work aimed to describe the epidemiological, clinical, biological and ultrasound aspects of the subclinical renal failure in hypertensive patients in the department of cardiology of the Gabriel TOURÉ University Hospital of Bamako.

PATIENTS AND METHODS

The study was cross-sectional and prospective from 1 January 2007 to 31 December 2007 in the cardiology department of the Gabriel Touré University Hospital. These were all patients who achieved at least the basic test for renal impairment such as serum creatinine, 24h proteinuria, renal ultrasound.

RESULTS

Total of 114 patients with kidney failure without evocative clinical symptoms have been included, among them 60 men and 54 women, average age of 57 years. In the hypertensive population, the beginner to moderate chronic renal failure had a frequency of 12.9% (114/880), the sex ratio was 1.11 in favor of men. Patients aged less than 60 years were more numerous with a frequency of 61.5%. Dyspnea (38.6%), and headache (36.8%) were the main manifestations of the high blood pressure (HBP). Renal disease characterized by microalbuminuria was predominant compared to the macro-albuminuria: 25.5% versus 7%. Renal ultrasound was abnormal in 14.1% with a predominance of stage 0 (86%), stages 1 and 2 were each 7%, we have not found any stage 3.

CONCLUSION

Chronic renal failure is a frequent complication of the hypertension. Some biological tests are necessary for the diagnosis. Renal ultrasound remains a useful test for its assessment. The optimal treatment of high blood pressure is essential, as it not only reduces the overall cardiovascular risk of patients, but also slows or even stabilizes the worsening of renal function.

[Clinical and therapeutic aspects of brain abscesses: 17 cases reviewed at the Gabriel Toure teaching hospital In Bamako]

OBJECTIVE

The purpose of this study was to determine the incidence, clinical features, localization, and therapeutic aspects of the evolution of the brain abscess.

PATIENTS AND METHODS

This was a retrospective study which included patients admitted for brain abscess at the Gabriel Touré Hospital in Bamako between January 2007 and September 2010.

RESULTS

We collated the data of 17 patients. Fever was the predominant symptom in 14 patients and headache in 13. The main clinical signs were hemiparesis (11 patients) and vomiting (8 patients). The origin of infection was especially posttraumatic in 5 patients, locoregional by contiguity in 5 where 3 whose originated in the sinuses. All patients received triple antibiotic therapy. The surgical management by trépanoponction was indicated in 16 patients. The clinical outcome was favorable in 14 patients. Three patients died.

CONCLUSION

Brain abscess is a common condition in Mali. Despite improved diagnostics and treatment of patients, mortality remains high hence the interest of prevention through early diagnosis and treatment of infectious ORL.

Antitrypanosomal and antiplasmodial activity of medicinal plants from Côte d'Ivoire

The antitrypanosomal activity of 101 crude ethanol extracts derived from 88 medicinal plants from Côte d'Ivoire was determined in vitro using Trypanosoma brucei rhodesiense. Of those extracts 8 showed good activity (IC50 values < or =8 microg/ml), 37 revealed a weak activity (IC50 values between 25 and 8.1 microg/ml) and 56 did not show any activity at all (IC50 values >25 microg/ml). The extracts of Enantia polycarpa (Annonaceae) and Trichilia emetica (Meliaceae) were the most promising ones. Their IC50 values were 0.5 and 0.04 microg/ml, respectively, and the selectivity index 616 and 209, respectively. This is the first report of in vitro antitrypanosomal activity of these two plants. Their high activities render them candidates for the isolation of compounds which could develop into new lead structures for drug development programs against African trypanosomiasis. Seven of the tested extracts exhibited an antiplasmodial activity against K1 strain of Plasmodium falciparum with IC50 values below 4 microg/ml. The highest activity was found for Enantia polycarpa stem bark with an IC50 value of 0.126 microg/ml.

On-line identification of the antifungal constituents of Erythrina vogelii by liquid chromatography with tandem mass spectrometry, ultraviolet absorbance detection and nuclear magnetic resonance spectrometry combined with liquid chromatographic micro-fractionation

In our continuing search for new antifungal agents of plant origin, the investigation of Erythrina vogelii Hook. f. (Leguminosae), a plant used in the traditional medicine of Ivory Coast to treat various infectious ailments, was undertaken. In order to rapidly identify the active principles, the crude extract was analysed by low-flow LC-1H nuclear magnetic resonance spectrometry (NMR) which gave a sensitive detection of all the main peaks. LC microfractionation was performed just after LC-NMR detection and all peaks collected were submitted to antifungal bioautography assays against Cladosporium cucumerinum. By this means, the antifungal activity could be efficiently linked to three of the LC peaks. In order to obtain complementary on-line structural information for all peaks of interest, high-resolution LC-MS-MS together with LC-UV with post-column addition of UV shifts reagents was undertaken on the crude extract. This chemical screening strategy with integrated antifungal bioassays has permitted the on-line identification of numerous constituents and has given useful information for an efficient peak-guided isolation procedure.

Evaluation of the antimicrobial potential of medicinal plants from the Ivory Coast

A total of 148 crude ethanol extracts from 115 plant species were tested in vitro against Gram-negative strains (Escherichia coli, Pseudomonas aeruginosa) and the Gram-positive Staphylococcus aureus and Enterococcus faecalis. Moreover, they were submitted to antifungal assays against Candida albicans and Cladosporium cucumerinum, a human and a plant pathogenic microorganism, respectively, known to be good indicators of antifungal activity. No activity was detected against the Gram-negative bacteria, while 14.8% and 10.8% of the extracts showed Gram-positive bactericidal or bacteriostatic effects on S. aureus and E. faecalis, respectively. An antifungal activity was observed with 15 extracts (10.1%). Two species were particularly active against the fungi: Dioscorea minutiflora and Erythrina vogelii. The young tubers of D. minutiflora contain metabolites with a specific effect on fungi and were not active against the bacteria. On the other hand, E. vogelii was highly effective against the Gram-positive bacteria and the fungi.

Three new prenylated isoflavonoids from the root bark of Erythrina vogelii

Phytochemical investigation of the CH2Cl2 extract of Erythrina vogelii led to the isolation of five isoflavonoids. Three prenylated isoflavonoids are new natural compounds. The isolation of the antifungal compounds was monitored by inhibition of the growth of Cladosporium cucumerinum in a direct TLC bioautographic assay. The structures of these compounds were elucidated by spectroscopic techniques.