Clinical use of the Sonic Air MM 1500 and the Meca Sonic 1400 in canal preparation in endodontics

INTRODUCTION: The preparation for canalisation has remained manual for a long time, technically constrictive and lasting for a long time. The application of ultrasound in Endontony allows us to tackle more calmly the canal course of the teath. The aim of this work is to make a qualitative comparison of the endosonic technique and the manual technique with reference to cases treated in the Dentisterie Opératoire clinic in Dakar. MATERIAL AND METHOD: 40 teeth of a complex canal anatomy and or in the posterior position in the buccal cavity were submitted to either a manual canalisation preparation or endosconic followed by monconic canal filling with a paste: 3 inc oxyde eugenol and iodoform. OPERATING FORMULA: Preparatory X rays: Allow us to evaluate the length of the work or the operating length after catheterisation: LO--length PRO, APEX RADIO-IMM LO--operating length PRO - occlusive point of reference The parietal support technique: The "synergetic" effect of ultrasonic oscillations of cavitation and of micro-acoustic currents associated with the action of the irrigation solution allow us to obtain canal incision. Instruments: the pneumatic Sonic Air MM 1500; the Meca Sonic MMR 1400 coupled to a standard ISO motor; SHAPERS and Meca Shapers. Activated by shaper or Méca Shaper. Classic monoconic canal filling: Wadding paste + zinc oxyde paste-iodoform eugenol. X rays for orthocentric monitoring. RESULTS--DISCUSSION: In 60% of the cases treated, the patients presented with a complete dentition. The third inferior molar was in almost all the cases, the cause of the patient seeking a dental consultation. By endosonic treatment-conservation of teeth which would otherwise have been destined for extraction; biopulectomy or instituted pulpectomy for cases of desdodontite, endosconic amplication and canal sealing after the cooling of the inflammation. Duration of treatment: 2 sessions for gangrenous cases or desmodondite and one session for biopulpectomy or pulpectomy, with 4 sessions in 10% of the cases. Operation times: Saving of time of 40-50%. If a second session was necessary, 15-20 minutes was sufficient. Incidents or accidents during or after the operation: breakage of instruments, post-operative inflammatory reaction. CONCLUSION: better distribution of the irrigation solution, lessening of the risk of infection, better quality of the state of the canal surface, reduction in operating time, precision and reliability, conservation of teeth which would otherwise have been extracted, as many of the elements which encourages the appreciation of ultrasound in endodonty.     

Localisation exceptionnelle au cône médullaire d’un neurofibrosarcome primitif

The neurofibrosarcoma or neurosarcoma is a rare malignant nerve sheath tumor with a lot of histological entities. It is associated with neurofibromatosis type 1 (NF1) in 70% of cases. We report the case of a 35-year-old patient without neurofibromatosis, who was diagnosed with a spinal neurofibrosarcoma cone. The intramedullary location of neurosarcoma is exceptional because of its histological nature, especially outside the context of neurofibromatosis. The treatment involves surgery, radiotherapy, and chemotherapy with a risk of local recurrence without systemic metastases trend.     

Trend in proportions of missed children during polio supplementary immunization activities in the African Region: Evidence from independent monitoring data 2010–2012

This is a comparative analysis of independent monitoring data collected between 2010 and 2012, following the implementation of supplementary immunization activities (SIAs) in countries in the three sub regional blocs of World Health Organization in the African Region. The sub regional blocs are Central Africa, West Africa, East and Southern Africa. In addition to the support for SIAs, the Central and West African blocs, threatened with importation and re-establishment of polio transmission received intensive coordination through weekly teleconferences. The later, East and Southern African bloc with low polio threats was not engaged in the intensive coordination through teleconferences. The key indicator of the success of SIAs is the proportion of children missed during SIAs. The results showed that generally there was a decrease in the proportion of children missed during SIAs in the region, from 7.94% in 2010 to 5.95% in 2012. However, the decrease was mainly in the Central and West African blocs. The East and Southern African bloc had countries with as much as 25% missed children. In West Africa and Central Africa, where more coordinated SIAs were conducted, there were progressive and consistent drops, from close to 20–10% at the maximum. At the country and local levels, steps were undertaken to ameliorate situation of low immunization uptake. Wherever an area is observed to have low coverage, local investigations were conducted to understand reasons for low coverage, plans to improve coverage are made and implemented in a coordinated manner. Lessons learned from close monitoring of polio eradication SIAs are will be applied to other campaigns being conducted in the African Region to accelerate control of other vaccine preventable diseases including cerebrospinal meningitis A, measles and yellow fever.     

Point‐of‐care testing can achieve same‐day diagnosis for infants and rapid ART initiation: results from government programmes across six African countries

IntroductionPoint‐of‐care (POC) early infant diagnosis (EID) testing has been shown to dramatically decrease turnaround times from sample collection to caregiver result receipt and time to ART initiation for HIV‐positive infants compared to centralized laboratory testing. As governments in sub‐Saharan Africa implement POC EID technologies, we report on the feasibility and effectiveness of POC EID testing and the impact of same‐day result delivery on rapid ART initiation within national programmes across six countries.MethodsThis pre‐/post‐evaluation compared centralized laboratory‐based (pre) with POC (post) EID testing in 52 facilities across Cameroon, Democratic Republic of Congo, Ethiopia, Kenya, Senegal and Zimbabwe between April 2017 and October 2019 (country‐dependent). Data were collected retrospectively from routine records at health facilities for all infants tested under two years of age. Hazard ratios and 95% confidence intervals were calculated to compare time‐to‐event outcomes, visualized with Kaplan–Meier curves, and the Somers’ D test was used to compare continuous outcomes.ResultsData were collected for 2892 EID tests conducted on centralized laboratory‐based platforms and 4610 EID tests on POC devices with 127 (4%) and 192 (4%) HIV‐positive infants identified, respectively. POC EID significantly reduced the time from sample collection to caregiver result receipt (POC median: 0 days, IQR: 0 to 0 vs. centralized: 35 days, IQR: 26 to 56) and time from sample collection to ART initiation for HIV‐positive infants (POC median: 1 day, IQR: 0 to 7 vs. centralized: 39 days, IQR: 26 to 57). With POC testing, 72% of infants received results on the same day as sample collection; HIV‐positive infants with a same‐day diagnosis had six times the rate of ART initiation compared to those diagnosed one or more days after sample collection (HR: 6.39; 95% CI: 3.44 to 11.85).ConclusionsSame‐day diagnosis and treatment initiation for infants is possible with POC EID within routine government‐led and ‐supported public sector healthcare facilities in resource‐limited settings. Given that POC EID allows for rapid ART initiation, aligning to the World Health Organization’s recommendation of ART initiation within seven days, its use in public sector programmes has the potential to reduce overall mortality for infants with HIV through early treatment initiation.     

Seed Coating with Mycorrhizal Fungal Spores and LEIFSONIA Bacteria: A Tool for Microbiological Fertilization and a Seed Protection Strategy From Insect Damage

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - We aimed to develop a coating process for maize and sorghum in order to simplify the application of microbial...     

Cerebral venous thrombosis in a sub-saharan African country: A preliminary monocentric study of a 70 case series at the neurology department of Fann teaching hospital in Dakar – Senegal

IntroductionCerebral venous thrombosis (CVT) are underdiagnosed in sub-saharan Africa where publications are uncommon. Our study aim was to describe the CVT diagnostic and therapeutic features through a senegalese case series.Patients and methodA monocentric retrospective and prospective study was conducted at the adult Neurology department of Fann Teaching Hospital in Dakar (Senegal), between January 01, 2013 and April 30, 2020. It had included all CVT cases diagnosed by neurovascular imaging.ResultsSeventy CVT cases were collected including 48 women (68.6%). The average age of the patients was 35.2 ± 14 years. The main neurological signs were headache (92.8%) and motor deficit (41.4%), with subacute onset in 67.2% of cases. The superior sagittal sinus (54.3%) and the transverse sinus (38.6%) were the most affected with multiple involvements in 27 patients (38.6%). Thirty patients (42.8%) had indirect parenchymal signs such as venous infarction (15.7%), cerebral edema (11.4%) or intracerebral hemorrhage (12.8%). The etiological factors were mostly infectious (41.4%) with meningoencephalitis (12.8%) and otorhinolaryngological infection (10%). Gyneco-obstetric factors (27%) and Behçet's disease (7%) were the main aseptic factors. In the short-term clinical course, curative anticoagulation (98.6%) had enabled a favourable outcome (mRS 0-1) in half of the patients.ConclusionOur study, the largest series in sub-saharan Africa to this date, confirms that CVT is a young women disease. Infectious etiology is the most frequent at the Fann national teaching hospital (41.4% in Dakar against 6.5% in Germaine Bousser's series) even if the etiological assessment is limited by financial constraints (no coagulopathy/thrombophilia check-up).     

Lack of inhibition of the anti-malarial action of sulfadoxine-pyrimethamine by folic acid supplementation when used for intermittent preventive treatment in Gambian primigravidae

Folic acid is frequently given to pregnant women at the same time as intermittent preventive treatment (IPTp) with sulfadoxine/pyrimethamine (SP), but it is not known if it interferes with the anti-malarial activity of SP. To investigate this concern, 1,035 Gambian primigravidae were randomized to receive either folic acid (500-1,500 microg/day) together with oral iron (522) or oral iron alone (513) for 14 days at the same time as they received IPTp with SP. On presentation, 261 women (25%) had Plasmodium falciparum asexual parasitemia. Prevalences of parasitemia on day 14 after treatment were similar in both groups: 5.7% (26 of 458) in the iron plus folic acid group and 4.9% (22 of 446) in the iron alone group (risk difference = 0.74%, 95% confidence interval [CI] = -2.2% to 3.7%). Parasitologic cure was observed in 116 (91%) of 128 of women who were parasitemic on presentation and who received iron and folic acid and in 122 (92%) of 133 women who received iron alone (difference = 1.1%, 95% CI = -5.6% to 8.0%). Women who received folic acid and iron had a slightly higher mean hemoglobin concentration at day 14 than women who had received iron alone (difference = 0.14 g/dL, 95% CI = 0.01-0.27 g/dL). The results of this study suggest that in an area of low SP resistance, administration of folic acid to pregnant women in a dose of 500-1,500 mug/day will not interfere with the protective effect of SP when used for IPTp.