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Objective: We aimed to gather fetal cases carrying a 7q11.23 copy number variation (CNV) and collect precise clinical data to broaden knowledge of antenatal features in these syndromes., Methods: We retrospectively recruited unrelated cases with 7q11.23 deletion, known as Williams-Beuren syndrome (WBS), or 7q11.23 duplication who had prenatal ultrasound findings. We collected laboratory and clinical data, fetal ultrasound, cardiac ultrasound and fetal autopsy reports from 18 prenatal diagnostic centers throughout France., Results: 40 fetuses with WBS were collected and the most common features were intra-uterine growth retardation (IUGR) (70.0%, 28/40), cardiovascular defects (30.0%, 12/40), polyhydramnios (17.5%, 7/40) and protruding tongue (15.0%, 6/40). Fetal autopsy reports were available for 11 cases and were compared with ultrasound prenatal features. Four cases of fetuses with 7q11.23 microduplication were collected and prenatal ultrasound signs were variable and often isolated., Conclusion: This work strengthens the fact that 7q11.23 CNVs are associated with a broad spectrum of antenatal presentations. IUGR and cardiovascular defects were the most frequent ultrasound signs. By reporting the biggest series of antenatal WBS, we aim to better delineate distinctive signs in fetuses with 7q11.23 CNVs., (© 2023 John Wiley & Sons Ltd.)

Background: Ethics in biomedical research is still a fairly new concept in Africa. This work aims to assess the knowledge, attitude and experiences of Beninese researchers with regard to the national ethical regulatory framework of biomedical research in Benin., Methods: This was a cross-sectional and descriptive study, involving all the researchers fulfilling the inclusion criteria. Data were collected through a face-to-face interview using a questionnaire and analysed. Proportions and means were calculated with their confidence intervals and standard deviations, respectively., Results: Of the 110 participants included in the study, 40.9% were medical lecturers and 71.1% had been involved in more than 10 biomedical research as researcher. Less than three quarters (69.1%) were able to correctly quote the basic principles from Belmont report. The quarter (25.45%) of them knew the attributions of the National Ethics Committee for Health Research (CNERS in French) and 38.2%, the content of the legislation on health research ethics in Benin. The common ethical rules were known by 69.1% of the participants. A quarter (25.5%) of participants said they always present the study's briefing note to their study participants and 62.7% said they systematically request informed consent. For those who do not present the briefing note to participants, the main reasons provided were the researchers' difficulties in writing the note in plain language and the participants' limitation in understanding it., Conclusions: The foundations of a good ethical framework for health research exist in Benin. However, the deployment and use of the various legal texts deserve to be improved., (© 2022. The Author(s).)

Purpose: To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures., Methods: A retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following parameters were studied: epidemiology, fracture characteristics, therapeutic, anatomical and functional outcomes. The correlation between different parameters was analyzed with Fischer test. The significant threshold was defined for p value <0.05., Results: Ten medical files were registered. There were 7 men and 3 women, with a sex ratio of 2.33. The average age was 46 years (range: 29-62 years). It was about traffic road accidents in all cases. Motorcycle-motorcycle and motorcycle-car collision were most frequent. Average admission delay was 7 h (range: 1.5-24 h). Left side was most reached in 8 cases. According to Garden classification, there was type III cervical fracture in 2 cases, type II in 1 case and type IV in 1 case. According to Ender classification, there was type I trochanteric fracture in 3 cases, type VI in 2 cases and type VII in 1 case. According to AO classification, there was type A shaft fracture in 6 cases (A2 in 4 cases and A3 in 2 cases), type B in 2 cases (B1 in 1 case and B2 in 1 case) and type C in 2 cases (C1 in 1 case and C2 in 1 case). Average surgical delay was 28.7 days (range: 11-61 days). For proximal femoral fracture, Moore prosthesis was used in 1 case, blade plate 130° in 2 cases, long Gamma nail in 4 cases, double screwing in 2 cases and dynamic hip screw in 1 case. For shaft femoral fracture, blade plate 95° was used in 3 cases, low compressive plate in 2 cases. Osseous contention was achieved in 4 cases with long Gamma nail and in 1 case with long blade plate 130°. Nonunion of cervical fracture was achieved in 2 cases. The average osseous healing delay was 5.14 months (range: 3-12 months) for proximal femoral fracture and 5 months (range: 3-8 months) for shaft femoral fractures. According to Friedman and Wyman criteria, functional results were good in 4 cases, average in 4 cases and bad in 2 cases. Regarding implants, healing delay showed no statistic difference between one-implant group and two-implant group (p = 0.52), and among the patients with different functional outcomes (p = 0.52). Functional outcomes showed no statistic difference between one-implant group and two-implant group (p = 0.46)., Conclusion: Ipsilateral proximal and shaft femoral fractures are relatively uncommon in our daily activities. It is difficult to recognize proximal femoral fractures which are unnoticed. Results are generally good if the doctors take the two fractures into account in the management., (Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.)

We made an inventory of the reasons for inhabitants of Benin are reluctant to undergo the amputation of a limb. A robust six-factor structure of motives was found: Change in Appearance, Lack of Information, Fear of Hospitals and Medical Staff, Loss of Others' Consideration and Affection, Denial of Necessity, and Spiritual and Religious Concerns. The first three motives were the most strongly endorsed. To improve people's timely acceptance, it is important to attack the main emotional-motivational barriers by using artificial limbs imitating real ones, by providing complete information on post-operative care and rehabilitation, and by strengthening family support.

Objectives: Assess the efficiency of internal iliac arteries ligation in intractable obstetrical hemorrhage and ascertain success or failure factors., Patients and Methods: It was a retrospective study which concerned 159 patients who underwent internal iliac arteries ligation for persistent and severe obstetrical hemorrhage from March 1992 to February 2007. Arrest of hemorrhage after ligation with survival of the patient was considered as successful; was considered as failure, persistence of hemorrhage in spite of the ligation or patient death., Results: Internal iliac arteries ligation allowed hemorrhage control in 84.3% of cases. Main etiology of hemorrhage were: uterine atony (42.8%), abruptio placentae (31.4%). Coagulation disorders and hypovolemic shock, consequences of long delay of management were identified as bad prognosis factors. Blood transfusion was also singled out as a factor likely to ameliorate prognosis, especially in hemodynamic precarious situations. Surgical complications incidence was 1.89%, represented by two internal iliac vein lesions and one ureteral section successfully repaired., Discussion and Conclusion: Internal iliac arteries ligation is a prerequisite treatment of severe postpartum hemorrhage. The outcome is better when it is performed precociously (p=0.0000003) before the happening of disseminated intra vascular coagulation (p=0.006), hemodynamic troubles (p=0.0099) and acute severe anemia (p=0.02). It is a good alternative to arterial embolization in Africa.

Conjoined twins are the rare malformations of monozygotic-twins pregnancies associated with bad fetal prognosis. Craniopagus are even more rarely encountered and their management is complex particularly in our low-medical-equipment countries. From an observation of craniopagus twins, we present several difficulties in the management of the case. Diagnosis was late; because of the onset of labour, delivery was not prepared; the conditions of neonatal and social management were not adapted. Surgical treatment was not considered owing to the absence of appropriate technological conditions and means.

The Authors report a rare case of praevia barrier from a duplex uterus (didelphys). A 30 Year old pregnant woman was admitted for ultrasound examination. Her past history included two cesarean sections with a stillborn infant in one case and a live infant with psychomotor retardation in the other case. Third trimester ultrasound examination was consistent with a 36-37 weeks gestation. A 9.1 by 5.8 cm retro-cervical praevia mass was also noted deep in the pelvis. The mass was similar in appearance to myometrium. Elective cesarean section performed at 38 weeks of gestation delivered a normal healthy 2950 g male infant and revealed a second non gravid uterus corresponding to the mass seen at ultrasound. Pelvic examination confirmed a diagnosis of uterus didelphys (uterus duplex bicornis bicollis with vaginal septum) separated by a sagittal partition. The post-operative course was uneventful. Praevia barrier by a half uterus in a patient with duplex uterus is a rare condition that can easily be detected by careful ultrasound examination thus preventing complications at delivery.

Unlabelled: Neonatal Marfan syndrome, the most severe presentation of Marfan syndrome phenotypes (MIM 154700), is characterised mainly by joint contractures, arachnodactyly, loose skin, crumpled ears, severe atrioventricular valve dysfunction and pulmonary emphysema. Death usually occurs within the first 2 years of life from congestive heart failure. We describe here a newborn male with many typical characteristics of neonatal Marfan syndrome associated with a diaphragmatic eventration and a bilateral uretero-hydronephrosis with bladder dilatation. He died from cardiac failure due to severe tricuspid and mitral regurgitation at 62 h of age., Conclusion: Molecular analysis showed a heterozygous missense mutation at nucleotide 3165 (3165T>G) in exon 25 of the FBN1 gene, resulting in the substitution of cysteine for tryptophan (C1055W).

To find out whether preventive antibiotic therapy can be justified in the practice of hysterosalpingography in a tropical environment where the infectious risk is notoriatly high, the authors performed a prospective study concerning 49 females patients. The patients in genital activity period, were willing and volunteers and were aged from 20 to 44 years. They were examined by hysterosalpingography during a period of three months. Patients were distributed in two homogenous group, one group of 25 patients who had a preventive antibiotic therapy and the second group with 24 patients with no preventive antibiotic therapy. Hysterosalpingography examinations were performed with sterile and single-use equipment. All patients were clinically examined for medical record purposes: gynaecologic, obstetric, pelvic infection, oral contraception, previous hysterosalpingography. Biologic dosages were realized, including blood count and erythrocyte sedimentation, culture of vaginal sampling, C reactive protein rate. The results obtained showed no significant difference between the two groups. The authors conclude that hysterosalpingography can be also performed in a tropical environment without using systematic preventive antibiotic therapy provided that asepsisrules are strictly observed.

We report a case of a rare and particular cause of abdominal calcifications represented by the lithopedion. We describe different radiologic appearances observed by: abdominal plain film, echography and CT. It appeared to us that abdominal plain film alone is sufficient for diagnosis and undertaking surgery. Echography and CT are helpful, especially for complementary evaluation.