Sternoclavicular septic arthritis is an unusual event in healthy patients. Cases have been reported in diabetes mellitus patients, intravenous drug abusers and patients affected by rheumatoid arthritis. We report a case of this unique infection that occurred in a patient who was not at risk of septic arthritis. Through this case and a review of the literature, we discuss the difficulty of diagnosing this disorder, and the consequences of delayed treatment in terms of life-threatening outcomes and therapeutic options.

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Background:The central Middle Atlas is a region renowned for its wealth of medicinal plants and ancestral knowledge of its local population in traditional pharmacopoeia. Thus, the main aim of this study is the valorization of poisonous medicinal plants and to provide an overview on the state of plant biodiversity of toxic medicinal plants, recommended by the actors of traditional medicine in this region Methods: The survey carried out involving actors of traditional medicine in the central Middle Atlas made it possible to establish a list of toxic medicinal plants recommended by these actors. A field survey was then conducted in order to identify the plants inventoried in the different sites of the study area, for taxonomic confirmation and /or determination.Results: Ethnobotanical survey allowed us to identify 123 medicinal plants used. Of these, 83 are declared toxic. The floristic prospection of these 83 toxic medicinal plants revealed that the majority of these plants are spontaneous herbaceous, with a rate of endemism of 8.34%. In addition, these plants are grouped into 74 genera and distributed over 36 families, of which the most represented are Lamiaceae (15.66%) and Asteraceae (14.46%). Also, the study revealed that Anacyclus pyrethrum L., Aristolochia paucinervis Pomel and Urtica urens L. are the most toxic plants used therapeutically. Moreover, the results show that for some plants, the most toxic parts are the most recommended by practitioners of traditional medicine in the study area, generally with internal use. Thus, the risks of poisoning are indisputable and accentuated by the recorded cases of confusion. Conclusion:The Middle Atlas is a region known for its flora biodiversity and especially for poisonous medicinal plants. The uncontrolled use of these plants can lead to sequelae and possibly serious intoxications.

RESUME Objectif : Cette étude consiste en une contribution à la valorisation du lentisque, très répandu dans la région de Meknès via une investigation ethnobotanique, un screening phytochimique et des tests antibactériens. Méthodologie et résultats : Une étude ethnobotanique a été menée à l'aide de fiches questionnaires auprès de la majorité des herboristes de la ville de Meknès ; ceci, afin de récolter le maximum d'informations sur les vertus et usages traditionnels de P. lentiscus L. L'enquête a révélé que le lentisque est couramment utilisé en thérapie (96%), surtout dans le traitement des affections gastrointestinales (88%), et dermatologiques (28%). Le feuillage et les jeunes rameaux sont utilisés sous forme de tisane (50%) et d'huiles essentielles (33%). A travers l'investigation phytochimique et des tests d'activité antibactérienne conduits avec des extraits de feuilles et de jeunes rameaux, il apparait que P. lentiscus L. est riche en métabolites secondaires. De son côté, l'huile essentielle et les différents extraits testés sont dotés d'une activité antibactérienne considérable. Conclusion et application de la recherche : L'étude ethnobotanique nous a permis de dévoiler le large éventail d'utilisation du feuillage de P. lentiscus L. dans le traitement de pathologies, notamment celles du tube digestif. Aussi, P. lentiscus L. est potentiellement important grâce à ses atouts en termes de biomasse, d'abondance sur le terrain, de richesse en métabolites secondaires (tanins, flavonoïdes, Stérols, triterpènes, et saponosides), d'effets antibactériens et de faible toxicité en rapport avec l'absence d'alcaloïdes et d'hétérosides cyanogénétiques.

IntroductionIsolated fracture of the trochlea is a rarely reported entity. To the best of our knowledge, only 15 cases have been published. We report the case of a patient with an isolated fracture of the trochlea and discuss through a literature review the underlying mechanisms and the clinical, radiological and therapeutic features of this lesion. This work will significantly advance our understanding of this particular fracture.Case presentationA 21-year-old Caucasian man received an elbow injury. An anteroposterior radiograph showed only an irregularity of the medial joint space, but a lateral radiograph showed an intra-articular half-moon-shaped fragment that had moved up and forward. A computed tomography scan confirmed an isolated fracture of his trochlea. Open reduction and internal fixation were performed with a good outcome.ConclusionAn isolated fracture of the trochlea is rare. The mechanisms generating this fracture are complex. As with other front-line fractures of the distal end of the humerus, such as the capitulum, we recommend open reduction and internal fixation for displaced fractures, with excision of the small osteochondral fragments that do not permit any osteosynthetic repair.

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Aqueous extracts of Corrigiola telephiifolia and Anacyclus pyrethrum were studied in vitro for their antimicrobial properties. These plants were collected from the Central Middle Atlas region. Corrigiola telephiifolia Pourr. and Anacyclus pyrethrum (L.) Link are widely used as a natural drug for the treatment of various infectious diseases. Phytochemical screening of the plants showed the presence of flavonoids, saponins, tannins, steroids and alkaloids. The determination of the polyphenols in the aqueous extract of the two plants revealed the presence of significant amounts of polyphenols (58.5 ± 0.76 mg equivalent of gallic acid (GEA) per gram of extract for C. telephiifolia, and 97.57 mg equivalent of gallic acid (GEA) per gram of extract of A. pyrethrum). The antimicrobial activity of the aqueous extracts against three bacterial strains was evaluated on the basis of the inhibition zone using the disk diffusion assay. The aqueous extract of Corrigiola telephiifolia is slightly active on E. coli. At a concentration of extract 100 μg mL-1, the size of the inhibition zone equal to 9 ± 0.06 mm. Whereas S. aureus, E. coli and K. pneumoniae showed a sensitivity to the macerate of Anacyclus pyrethrum at the concentration 100 μg mL-1 of extract with an inhibition zone 16.55 ± 0.6 mm, 14.95 ± 1.25 mm and 10.83 ± 0.96 respectively.