No abstract

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

No abstract

African histoplasmosis is a rare but not an exceptional condition and recently discovered in Madagascar. We report the fifth Malagasy case involving skin and nodes in an immunocompetent patient. Management of African histoplasmosis encountered many problems because of the availability of amphotericin B and cost of the biochemical tests in order to prevent major side effects in case of failure of oral antimycotic drug.

Background: The betablockers combined with endoscopic variceal band ligation (EVL) is the most effective prevention of variceal rebleeding. The aim of this study is to evaluate the efficacy and safety of carvedilol compared to propranolol as secondary prevention of variceal bleeding in hepatic schistosomiasis. Methods: All patients with portal hypertension due to schistosomiasis presenting for EVL with at least one episode of variceal bleeding were included and randomized into propranolol + EVL and Carvedilol + EVL groups. Results: Sixty-one patients were selected and randomized into the propranolol group (n=30) and carvedilol group (n=31). We noted less recurrence of bleeding in the carvedilol group (n=1) than in the propranolol group (n=3) (3.33% vs 10%; p=0.30). Bleeding recurrence occurred after 30 days in the carvedilol group and after 5, 45 and 90 days in the propranolol group. At 4 months, a significant reduction in mean arterial pressure (-4.13 mmHg; 95%CI: -6.27 and -1.99; p <0.05) and heart rate (-12.13 mmHg; 95%CI: -13.92 and -10.35; p<0.05) was found in the carvedilol group. There was no significant difference between the two groups on the mean difference in mean arterial pressure. A patient in the carvedilol group presented breathing difficulty. No adverse effects have been demonstrated in the propranolol group. Conclusion: Carvedilol is as effective as propranolol in the prevention of variceal rebleeding in hepatic schistosomiasis.

Post-malaria neurological syndrome is a rare complication of malaria. Typically, it occurs in case of severe malaria. Here we report a case in a Malagasy patient presenting a non-severe Plasmodium falciparum malaria complicated by post-malaria neurological syndrome. The management of such a syndrome is radically different from non-severe malaria. No specific treatment is needed.

This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

It is essential to differentiate intestinal tuberculosis from Crohn's disease because of the therapeutic implications of Crohn's disease, which can exacerbate the symptoms of tuberculosis.