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Urolithiasis is a global pathology with increasing prevalence rate. The lifetime recurrence of urolithiasis ranges from 10–75% creating a public health crisis in affected regions. The epidemiology of urolithiasis in most parts of Africa and Asia remains poorly documented as incidence and prevalence rates in these settings are extrapolated from hospital admissions. The surgical management of kidney and ureteral stones is based on the stone location, size, the patient’s preference and the institutional capacity. To date, the available modalities in the management of urolithiasis includes external shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopy (URS) including flexible and semirigid ureteroscopy. However, regarding the lack of endourological equipment and expertise in most parts of Sub-Saharan Africa (SSA), most urological centers in these regions still consider open surgery for kidney and ureteral stones. This review explores the current trend and surgical management of upper tract urolithiasis in SSA with insight on the available clinical guidelines.

To assess tocilizumab (TCZ) efficacy associated to standard of care (SOC) compared to SOC alone in severe coronavirus associated disease 2019 (COVID-19) patients. In a matched case-control study from 3 French Hospital COVID-19 Departments, 27 patients with severe COVID-19 treated with TCZ and SOC were matched for baseline epidemiological and clinical features and compared to 27 severe COVID-19 patients treated with SOC alone. Baseline characteristics of the study population were comparable between groups. Eleven patients (20%) died. TCZ was not associated with clinical improvement as compared to SOC regarding oxygen-free status (44% vs 63%) and death (18.5% vs 22%), despite a higher decrease of the C-reactive protein at Day 7 (10.7 vs 52 mg/L; P

Ayun Cassell,1 Mohamed Jalloh,1 Medina Ndoye,1 Bashir Yunusa,2 Mouhamadou Mbodji,1 Abdourahmane Diallo,1 Omar Gaye,1 Issa Labou,1 Lamine Niang,1 Serigne Gueye1 1Department of Urology and Andrology, Hopital General de Grand Yoff, Dakar, Senegal; 2Department of Surgery, Liberia College of Physicians and Surgeons, Monrovia, LiberiaCorrespondence: Ayun CassellDepartment of Urology and Andrology, Hopital General de Grand Yoff, Dakar, SenegalTel +221770135805Email ayuncasselliii@gmail.comAbstract: Testicular cancer is a common malignancy in young males with higher incidence in developed nations but with the lowest incidence in Africa (0.3– 0.6/100 000). Ironically, the global testicular cancer mortality rate has shown a reverse trend to its incidence with higher rates in low- and middle-income countries (0.5 per 100 000) than in high-income countries. Data from GLOBOCAN 2008 have shown relatively high mortality rates in sub-Saharan countries like Mali, Ethiopia, Niger and Malawi. The prognosis of testicular tumor is good with remarkable chemosensitivity to cisplatin-based regimen. Early diagnosis, careful staging and a multidisciplinary management approach is crucial to achieve this optimal result. These results are achievable in the sub-Saharan region if the relevant resources are appropriated for cancer care and clinical guidelines are formulated in a regional context.Keywords: germ cell, orchidectomy, testicular cancer

Background. Globally, approximately 20% of malignancy are caused by infection. Schistosoma infection is a major cause of bladder in most part of Africa. In 2018 alone, there were approximately 549,393 new cases and 199,922 deaths from bladder cancer. The presence of Schistosoma ova in the venous plexus of the bladder induces a cascade of inflammation causing significant tissue damage and granulomatous changes. Methodology. A literature review was conducted from 1995 to 2019 using PubMed, Google Scholar, African Journal Online, and Google databases. Relevant data on the association of “Schistosomiasis and Bladder cancer” in sub-Saharan Africa (SSA) were retrieved. Evidence Synthesis. Results from research using animal models to establish the carcinogenesis of Schistosoma and bladder cancer have been helpful but inconclusive. Immunoregulatory cytokines and genetic marker have been identified to play a role in the pathogenesis. In some parts of sub-Saharan Africa, there has been close association of squamous cell carcinoma and histological evidence of Schistosoma ova. Conclusion. There are some data to support the association between schistosomiasis and bladder cancer in sub-Saharan Africa. However, these have been limited by their design and may not sufficiently establish carcinogenesis. There is a need for more genomic and molecular research to better characterize S. haematobium and its effects on the bladder. Such goal will contribute immensely to Schistosoma bladder cancer prevention and control.

International audience; L'objectif de cette étude est d’évaluer les effets de l'application de différents fertilisants organiques (fumier de vache, litières de Balanites aegyptiaca (L.) Del., Boscia senegalensis (Pers.) Lam. ex Poir. et Sclerocarya birrea (A. Rich.) Hochst) sur les paramètres de croissance et de rendement de la variété F1 Mongal de la tomate (Solanum lycopersicum L.) en conditions semi-contrôlées. L’étude a été effectuée à la ferme agricole de l’Université Gaston Berger de Saint Louis au Nord du Sénégal entre avril et juin 2018. Le dispositif expérimental utilisé est en blocs aléatoires randomisés avec quatre (04) répétitions, huit (08) traitements et trois (03) doses (0,2%, 0,5% et 0,8%). Les traitements appliqués sont : T0 (témoin sans apport de fertilisant), T1 (litière de Balanites aegyptiaca), T2 (litière de Boscia senegalensis), T3 (litière de Sclerocarya birrea), T4 (fumier), T5, T6 et T7 (mélange à proportion égale (½+ ½) de fumier et chacune des trois (03) litières). Après application des différents fertilisants organiques, une durée de décomposition de 15 jours a été observée avant semis dans des pots de 1,5 kg. Après 60 jours de croissance, les résultats obtenus ont montré que les effets sur la croissance de la tomate varient en fonction de la dose et de la qualité de la matière organique apportée. Les litières de B. senegalensis appliquées seules ou en combinaison avec le fumier et la litière B. aegyptiaca utilisée seule ont amélioré significativement certains des paramètres étudiés (hauteur, surface foliaire, biomasse sèche aérienne et couleur du feuillage) aux doses de 0,5% et 0,8%. Les meilleurs effets ont été induits par la plus forte dose (0,8%) de B. senegalensis. La litière de S. birrea n’a pas eu d’effets significatifs sur les paramètres de croissance et de rendements de la tomate. Le fumier n’a montré aucun effet sur les paramètres de croissance de la tomate par rapport au témoin sans fertilisant. Ainsi, la litière de B. senegalensis dans les conditions de cet essai, a montré un grand potentiel pour l’amélioration des paramètres de croissance et de rendement de la tomate.

International audience; Background: We sought to determine whether the risks and benefits of prolonging dual-antiplatelet therapy (DAPT) beyond 1 year after drug-eluting stent implantation depend on clinical presentation in a meta-analysis of randomized controlled trials.Methods and results: Randomized controlled trials comparing ≤1- versus >1-year DAPT after drug-eluting stent placement were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings. The primary efficacy end point was myocardial infarction, whereas the primary safety end point was major bleeding. Net clinical benefit was defined as the composite of myocardial infarction or major bleeding. Outcomes were analyzed according to patient presentation with stable ischemic heart disease versus acute coronary syndromes. The meta-analysis included 6 trials with a total of 21 457 patients, including 14 132 with stable ischemic heart disease and 7325 with acute coronary syndrome. After a median follow-up of 19.5 months, ≤1-year DAPT was associated with higher rates of myocardial infarction compared with >1-year DAPT (hazard ratio [HR], 1.63; 95% CI, 1.37-1.95), with no interaction apparent between treatment effect and clinical presentation. Shorter DAPT was associated with reduced rates of major bleeding compared with longer DAPT (HR, 0.64; 95% CI, 0.42-0.99) with no significant interaction between treatment effect and clinical presentation. However, a net clinical benefit of >1-year DAPT was present in patients with acute coronary syndrome (HR of shorter versus longer DAPT, 1.59; 95% CI, 1.24-2.02) but not in those with stable ischemic heart disease (HR, 1.15; 95% CI, 0.89-1.51; Pinteraction=0.04). Shorter DAPT was also associated with lower rates of noncardiac mortality compared with longer DAPT (HR, 0.71; 95% CI, 0.52-0.96), with no significant interaction between treatment effect and clinical presentation ( Pinteraction=0.12).Conclusions: Compared with ≤1-year DAPT, >1-year DAPT reduces the risk of myocardial infarction but increases the risk of major bleeding and noncardiac mortality. A net clinical benefit of extended DAPT was apparent for patients with acute coronary syndrome but not for those with stable ischemic heart disease.

The estimated incidence rate of prostate cancer in Africa was 22.0/100,000 in 2016. The International Agency for Research on Cancer (IARC) has cited prostate cancer as a growing health threat in Africa with approximated 28,006 deaths in 2010 and estimated 57,048 deaths in 2030. The exact incidence of advanced and metastatic prostate cancer is not known in sub-Saharan Africa. Hospital-based reports from the region have shown a rising trend with most patients presenting with advanced or metastatic disease. The management of advanced and metastatic prostate cancer is challenging. The available international guidelines may not be cost-effective for an African population. The most efficient approach in the region has been surgical castration by bilateral orchidectomy or pulpectomy. Medical androgen deprivation therapy is expensive and may not be available. Patients with metastatic castrate-resistant prostate cancer tend to be palliated due to the absence or cost of chemotherapy or second-line androgen deprivation therapy in most of Africa. A cost-effective guideline for developing nations to address the rising burden of advanced prostate cancer is warranted at this moment.