Place of urolithiasis in the spectrum of urological pathologies, practices and use of endourological procedures in the management of calculi of the upper urinary tract: results of a survey of referral centres in Africa.

Our aim was to determine the current trend of endourology in the management of upper urinary tract calculi in Africa reference centres. We conducted an online multiple-choice questionnaire survey involving 46 centres from 27 countries using a structured well-designed Google Form (®) questionnaire. The questionnaires were distributed to the head of service through their emails.

[Huge aspergilloma developed within a zone of scleroderma-related pulmonary fibrosis].

In pulmonary aspergilloma, Aspergillus colonizes and proliferates as a saprophyte in deterged cavities deprived of local defense. Although pulmonary tuberculosis constitutes the one well-know predisposing factor, other causes can create favorable conditions. We describe a first published case of a huge aspergilloma which developed within a zone of pulmonary fibrosis secondary to systemic scleroderma.

[A case of curable encephalomyelitis in a tropical area: pernicious anemia].

Pernicious anemia is uncommon in Africa. The purpose of this report is to describe a case of pernicious anemia observed in Madagascar. The revealing manifestation was encephalomyelitis with combined medullar sclerosis that responded favorably to vitamin B12 replacement therapy.

[A rare case of huge aspergilloma developed within a lesion of pulmonary fibrosis secondary with a systemic scleroderma in an immunocompetent patient in Madagascar].

We report a rare case of a huge aspergilloma developed within a bronchiectasis due to pulling by a pulmonary fibrosis of systemic scleroderma. The patient is a 58-year-old woman presenting a deterioration of the general state associated with repeating hemoptysis, dyspnea, dysphagia, sclérodactylia, generalized cutaneous sclerosis and Raynaud's phenomenon. There was no antecedent pulmonary tuberculosis.

[Portopulmonary hypertension due to schistosomiasis in two Malagasy patients].

Portopulmonary hypertension is characterized by a chronic liver disease associated with a mean pulmonary artery pressure >25 mmHg at rest, an increased pulmonary vascular resistance and a capillary pulmonary pressure <15 mmHg with portal hypertension. Schistosomiasis may be an aetiology of this syndrome, however, few cases have been reported. We describe the first cases of portopulmonary hypertension with schistosomiasis in Malagasy patients.

[Costs directly related to acute lower respiratory tract infections in the pediatric hospital milieu].

The purpose of this retrospective study carried out by 1997 in two paediatric units of Antananarivo: paediatric unit of the General hospital of Befelatanana (Marfan) and paediatric unit of the Hospital Center of Soavinandriana (CI), was to evaluate direct service costs for an hospitalization of a child affected by lower acute airway diseases. In the first unit, there is partial charge, in the second, there is full charge. Direct services were continued by complementary tests, therapy and meals.

[Evaluation of the use of antibiotics in the hospital pediatric milieu].

Excessive and inappropriate use of antibiotics is a world-wide serious problem because it contributes to the development and the spreading of antibiotic resistance. The authors carried out a study for one year by 1998, in order to evaluate antibiotic prescriptions in three childhood diseases: respiratory, digestive and neurological diseases. Patients hospitalized at the unit paediatric of the General hospital of Befelatanana are 0 month to 15 years old.

[Value of C-Reactive Protein (CRP) in childhood fever conditions].

C-Reactive Protein (CRP) measurement is used to orientate the diagnosis of an inflammation especially in childhood febrish diseases. A retrospective study was carried out at the pediatric service of the General hospital of Befelatanana in Antananarivo for 48 months (1997-1998). The population of this study was continued of 361 patients taken from 714 febrish children.

[Study of idiopathic thrombopenic purpura in two pediatric services of Antananarivo city].

Idiopathic thrombocytopenic purpura (ITP), haematologic disease affecting the only blood platelets, is an acquired disease. It appears as cutaneous and mucosal bleedings preceded by a feverish syndrome. Cerebral haemorrhage is possible but very rare.

[Influenza in the pediatric hospital unit at Antananarivo].

62 rhinopharingeal samples from malagasy children, aged of 6 days to 14 years old, hospitalized because of acute respiratory infections, with doubtful viral etiology case, during June to August 1992, at the "Hôpital des Enfants" in Antananarivo, were examined by two methods: inoculation by embryonned eggs and inoculation by MDCK cells. 24.1% of the samples were positive.

[Management of multiple pregnancies at the Befelatanana Antananarivo University Hospital Center (Madagascar): report of 143 cases].

Multiple pregnancies (MP) outcomes are often complicated. They deliver premature infants and provoke high blood pressure. A retrospective study was carried out in 1998 at the Maternity Hospital of Befelatanana, Antananarivo in order to assess MP frequency and to specify the most important favourising factors and difficulties during labor and the quality of the labor management.

[Premature rupture of membranes seen at the Befelatanana maternity, Antananarivo University Hospital Center].

Generally preterm ruptures of membranes (PRM) are harmless, but they become serious if the labor doesn't occur in the following 24 hours. Then, they might generate neonatal infections which provoke heavy fetal and maternal mortality. A retrospective study was carried out in 1998 at the Maternity Hospital of Befelatanana, Antananarivo in order to sum up knowledges on epidemiology and fetal prognosis of this disease, and to draw up measures to aim to reduce causes of PRM.

[Internal version maneuvers at the maternity hospital of Befelatanana--Antananarivo University Hospital Center (Madagascar): 177 cases].

Version by internal manipulations (VIM) cause high fetal and maternal morbidity and mortality rates. A retrospective study was carried out in 1998 at at the Maternity Hospital of Befelatanana, Antananarivo in order to assess VIM frequency, to specify their indications and technical difficulties by performing them. 177 VIM were registered for the period study: 85 on singleton pregnancies, 91 on the second twin and 1 on the third infant of a triplet pregnancy.

[Premature deliveries at the maternity hospital of Befelatanana, Antananarivo in 1997].

Preterm deliveries (PT) produce new-borns whose prognosis is generally very dark. Prematurity is the first cause of neonatal death. A retrospective study was carried out at the Maternity Hospital of Befelatanana, Antananarivo in order to specify causes and difficulties of PT and to draw up strategy for their better management so that premature infants have chance to survive.

[Cases of abortions at the maternity hospital of Befelatanana in 1997].

The purpose of this study is to assess the frequency of spontaneous and induced abortions at the Hospital Maternity of Befelatanana, in Antananarivo--City by 1997. The study was also carried out to identify causes and risk factors of abortions in order to draw up a control program. 958 abortion cases were counted.

[Neonatal bacterial infections: a public health problem at the maternity hospital of Befelatanana (1997-1998)].

Neonatal infections represented the second cause of morbidity at the neonatalogy service of the Maternity Hospital of Befelatanana, and they were the first cause of the perinatal mortality (81%). This prospective study was carried out from May 1997 and December 1998 and had concerned neonatal infections suspicions among newborns. Its purpose was to identify problems with regard to the management of those newborns and to assess the impact of the prevention.

[Evaluation of the management of tuberculosis in children in Madagascar. Results of a multicentric study].

In Madagascar, tuberculosis remains an important cause of morbidity and letality with a Risk of Annual Tubercular Infection about 1% in 1996 in spite of a vaccination rate of 82.6% and tubercular drugs free of charge. In 1995, the National Tubercular Control Program detected 7,000 cases of pulmonary tuberculosis and expected more than 12,000 cases per year.

[Aspects of primary tuberculosis infection in children: 27 cases observed at Children's Hospital, Antananarivo].

A retrospective study on tubercular primary infection in children was carried-out for 18 months (January 1994--June 1995) at the Child Hospital of Tsaralalana in Antananarivo-City. 27 cases were reported. The sex-ratio was of 1,01/1.

[Mediastinal form of cat-scratch disease].

The authors reported a case of Cat--Scratch Disease (CSD) in a 14-year-old boy; it was an unusual CSD by its mediastinal mass location. Histopathological lesions which appeared as pseudo-tubercular folliculi mislead us. Disease was finally diagnosed by biological exams: a strongly positive Hanger-Rose reaction and serological assays used for the diagnosis of psittacosis, ornithosis, lymphagranuloma venereum and trachoma.

[First cases of cholera observed in children at the Befelatanana General Hospital--Antananarivo University Hospital Center (Madagascar)].

Ravages caused by cholera among children are well known. The disease invaded Madagascar in 1999 May. This retrospective study reported the first childhood cholera cases.

[Epidemiological aspects of acute pelvic pain of gynecologic origin at the maternity of the Befelatanana Hospital Center, Antananarivo].

Acute pelvic pains of pregnancy (APPP) generate a lot of social and professional problems to pregnancy. A retrospective study was carried out in 1996 at the Maternity Hospital of Befelatanana, Antananarivo in order to specify epidemiological feature of APPP suffering pregnancy and to search favourising factors and determinative causes of this disease so that a strategy will be drawn up to reduce its frequency and to organize correct cares. 1,612 APPP were registered for the study period, i.

[Diagnostic pitfalls in childhood acute obstructive dyspnea].

Diagnosis of an acute obstructive dyspnea is very difficult because there are many possible causes. The authors reported the case of a 3.5-year-old boy with an atopic status who presented iterative asthma attacks which evolute to severity in spite of an appropriate therapy.