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Knee Osteoarthritis Progression after Distal Femur Closing Wedge Osteotomy

Open Journal of Orthopedics 2024年第4期14卷 187-199页

作者： Ferdinand Nyankoué Mebouinz Khalifa fall Kennedy Muluem Justine Raphaela Nyekel Moustapha Niane alioun. badara Gueye Daniel Handy Eone Charles Valerie Kinkpé Department of Surgery and Specialties The Faculty of Medicine and Biomedical Sciences The University of Yaound&#233 I Yaound&#233 Cameroon Department of Orthopedic and Trauma Surgery Cheikh Anta Diop University of Dakar Dakar Senegal Department of Surgery and Specialties The Faculty of Medicine and Pharmaceuticals Sciences The University of Douala Douala Cameroon

Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to identify the factors associated with the progression of knee osteoarthritis after a medial closing-wedge distal femoral osteotomy. Methods: Hospital-based observational study on 20 patients who underwent a medial closing-wedge distal femoral osteotomy evaluating the progression of osteoarthritis using the Kellgren and Laurence classification. The Wilcoxon test was used to compare the variation in the progressive stage of the Kellgren and Laurence classification of knee osteoarthritis preoperatively and at the final follow up. Univariate analysis made it possible to determine the factors associated with progression. The final significance threshold for statistical tests was set at 5% (p Results: Overall, the mean follow-up of 46 months ± 6.6 months, with a mean age of 43 years (range: 27 - 69 years) and a female predominance (M: F = 3/7). The progression of tibiofemoral osteoarthritis following a medial closing-wedge distal femoral osteotomy is associated with valgus or varum malalignment been a moderate valgus (OR 6.2 [1.5 - 42.7] at 95% CI;p-value = 0.02), a correction of the mechanical deviation angle with a valgus alignment (OR 2.7 [0.9 - 8.3] at 95% CI), and loss of correction (OR 3.8 [1.3 - 11.6] at 95% CI;p -value) for the lateral compartment while varus alignment (OR 1.7 [0.9 - 8.3] 95% CI, p-value = 0.05) and with rupture of the lateral cortex (OR 2.8 [1.7 - 11.5] 95% CI, p-value = 0.02) were those of the medial compartment. Conclusion: Distal femur closing wedge osteotomy does not definitively interrupt the progression of valgus knee osteoarthritis. The factors associated with the progression of this pathology are modifiable. Taking them into account when performing this surgical technique could improve the osteotomy survival curve.

关键词： Knee Osteoarthritis Progression Osteotomy Distal Femur

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Study of Factors Associated with Knowledge, Attitudes and Practices Regarding Rabies in the Commune of Niakhéne in Senegal, in 2022

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Open Journal of Epidemiology 2024年第1期14卷 180-197页

作者： Boubacar Gueye Martial Coly Bop Ndéye Marième Diagne Khadija Barro Cheikh Tacko Diop alioun. badara Tall Papa Gallo Sow Mountaga Dia Abdoul Aziz Ndiaye Ousseynou Ka Training and Research Unit for Health and Sustainable Development Alioune Diop University of Bambeye Bambeye Senegal Dakar Principal Hospital Dakar Senegal Health and Development Institute Cheikh Anta Diop University of Dakar Dakar Senegal

Introduction: Rabies is a serious disease, as it is always fatal, but it can be prevented by sero-vaccination. It is a neglected tropical disease endemic in Asia and Africa. The aim of this study was to assess knowledge, attitudes and practices regarding rabies and to determine the factors associated with them among people aged 18 and over in the commune of Niakhène. Methods: This was a cross-sectional, descriptive and analytical survey of subjects aged 18 and over living in the commune of Niakhène. A sample of 300 individuals was drawn from a two-stage cluster survey stratified by age and sex. Bivariate analysis was performed using association tests. Results: The mean age of respondents was 35.3 ± 16.9 years. It was noted that 67% (201) of respondents had a good knowledge of rabies. The results showed that 7.3% (22) of respondents owned a dog. Of the 278 people who did not own a dog, 78.4% (218) said they would have vaccinated their dog if they had had one. It should be noted that 83.7% (251) of respondents said they would go to a health facility if an animal bit them. None of the dog owners had vaccinated their dogs against rabies. Of the 41 people exposed to rabies, 39% went to a health facility. The age and education of the respondents had statistically significant associations with knowledge of rabies. Respondents’ age and education were statistically significantly related to whether they had vaccinated a domestic dog. The age, education and economic well-being quintile of respondents’ households had statistically significant associations with the use of a health facility in the event of being bitten or scratched by an animal vector. The education of respondents who had been bitten by an animal vector was statistically significantly associated with the use of a health facility. Conclusion: It would be imperative for human and animal health authorities to collaborate in a “One Health” approach in order to increase knowledge and promote the adoption of good pract

关键词： Rabies Knowledge Attitudes Practices Associated Factors Senegal

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Assessment of Satisfaction in the Reception and Emergency Department of a Health Center

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Open Journal of Epidemiology 2024年第2期14卷 284-296页

作者： Boubacar Gueye Martial Coly Bop NdéyeMarième Diagne Cheikh Tacko Diop alioun. badara Tall Papa Gallo Sow Mountaga Dia Abdoul Aziz Ndiaye Ousseynou Ka Training and Research Unit for Health and Sustainable Development Alioune Diop University of Bambeye Bambey Senegal Dakar Principal Hospital Dakar Senegal Health and Development Institute Cheikh Anta Diop University of Dakar Dakar Senegal

Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregive

关键词： Assessment Satisfaction Reception Ad Emergency Department Health Center

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Rectitis Radiation a Problem of Therapeutic Management in Senegal about Two Cases

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Open Journal of Gastroenterology 2022年第11期12卷 330-335页

作者： alioun. badara fall Nogoye Niang Alsine Yauck Mouhamed Sidibe Marieme Pole fall Cheikh Anta Diop University of Dakar Hospital Aristide Le Dantec Dakar Senegal

Radiotherapy occupies an important place in the management of cancers of the pelvic-perineal organs, it is at the origin of the fact of the ionizing radiations of radiation proctitis which is most often revealed by hematochezia. Diagnosis is based on rectoscopy which highlights a telengiectatic proctitis aspect. The standard treatment is endoscopic and based on argon plasma electrocoagulation. We report two cases of radiation proctitis occurring a few months after radiotherapy. Case number 1: A 76-year-old hypertensive patient known to have a history of cancer of the cervix treated with radiochemotherapy, she was received in an array of hematochezia of medium abundance;total colonoscopy found an aspect of telengiectatic proctitis making retain radiation proctitis. She had benefited from medical treatment, however, after a two-month follow-up, there was a recurrence of rectal bleeding despite medical treatment, due to the unavailability of endoscopic treatment based on argon plasma, surgical treatment of a type of protectomy had been carried out on postoperative follow-up was marked by a regression of hemorrhage with the occurrence of a. Case number 2: An 87-year-old patient, hypertensive, with a history of prostate adenocarcinoma 3 years ago treated with brachytherapy and hormone therapy;he was hospitalized with hematochesia. Rectosigmoidoscopy found an aspect of telengiectatic proctitis. The diagnosis of radiation proctitis had been retained and the patient had received medical treatment. The short-term evolution was marked by an amendment of the hematochezia with a long-term recurrence requiring endoscopic destruction via the diathermic loop of the telengiectatic lesions with good evolution without relapse after the procedure. Conclusion: Radiation proctitis is a major side effect of pelvic radiotherapy. Management is very difficult in our regions due to the unavailability of endoscopic means, in particular argon plasma.

关键词： Radiation Proctitis Hematochesia Telangiectasias

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Differential Diagnosis Difficulty between Biliary Cystadenoma and Cystaadenocarcinoma of the Liver: A Case Report

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Open Journal of Gastroenterology 2023年第1期13卷 61-65页

作者： alioun. badara fall Marieme Polele fall Salamata Diallo Marie Louise Bassene Alsine Yauck Coumba Cisse Tene Sidibe Cheikh Anta Diop University of Dakar Hospital Aristide Le Dantec Dakar Senegal

Biliary cystadenoma is a multilocular cystic benign tumor which arises in the intrahepatic biliary system. Diagnosis is often difficult and based on imaging, however histology remains the only argument for diagnosis certainty. We report a case of biliary cystadenoma in a 69-year-old female. Observation: it was a 69-year-old female with history of RHUPUS syndrome (Lupus + Rheumatoid arthritis) under low-dose corticosteroid therapy. She presented with pain in the right hypochondrium with permanent moderate intensity for 3 months associated to altered performance status. Physical examination showed a hepatomegaly, cervical subluxation, and pulmonary condensation syndrome. Hepatobiliary ultrasound showed presence of multiple septate cystic formations occupying segments 1, 7, 8, 5 of the left liver. Abdominal CT scan and hepatic MRI were in favor of biliary cystadenoma but could not rule out biliary cystadenocarcinoma with certainty. Conclusion: biliary cystadenoma is a benign cystic tumor of the liver. The differential diagnosis with cystadenocarcinoma is most often difficult and usually requires histological analysis for diagnostic certainty.

关键词： Cyasdenoma Cysadenocarcinoma Bile Duct

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Clinical Characteristics of COVID-19 Patients with Digestive Symptoms: A Retrospective Study from Dakar, Senegal

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Open Journal of Gastroenterology 2022年第4期12卷 89-97页

作者： Salamata Diallo alioun. badara fall Marie Louise Bassene Mamadou Ngoné Gueye Marieme Polele fall Mame Aissé Thioubou Alsine Yauck Abdoul Aziz Atteib fall Atoumane Faye Department of Gastroenterology and Hepatology Hospital Aristide Le Dantec Dakar Senegal Department of Gastroenterology and Hepatology Hospital Idrissa Pouye Dakar Senegal Department of Gastroenterology and Hepatology Peace Hospital Ziguinchor Senegal Department of Internal Medicine Hospital Aristide Le Dantec Dakar Senegal

Introduction: As of February 2022, coronavirus disease 2019 (COVID-19) has caused a pandemic affecting all countries, with a total of 399 million patients and 5 million deaths. The lungs are the major organs involved in COVID-19. COVID-19 infection is not limited to the respiratory system but can affect multiple organs including the gastrointestinal tract. The aim of our study was to assess the prevalence of gastrointestinal (GI) symptoms on admission in patients with COVID-19 and their association with adverse outcomes, including mortality. Methods: In a retrospective study, we examined medical record data from patients with SARS-CoV-2 infection admitted to epidemic treatment center of hospital Aristide Le Dantec, Dakar (Senegal) between May 1, 2020, and June 31, 2021. SARS-CoV-2 infection was diagnosed by real-time polymerase chain reaction on nasopharyngeal and throat swabs. We included all patients with SARS-CoV-2 infection and GI symptoms. Result: The study identified 472 hospitalized patients with confirmed SARS-CoV-2 infection during the study period. We recruited 222 patients with gastrointestinal symptoms. The mean age of patients with GI symptoms was 56 years [17 - 90 years], and 54.9% were male. Patients with GI symptoms had comorbidities in 66.2% of cases. Hypertension, diabetes mellitus and chronic kidney disease were the most common comorbidities at 29.3%, 23.9%, and 6.7%, respectively. Patients with GI had cough in 69.4%, shortness of breath in 61.7%, ageusia in 57.6%, and fever in 53.1%. At presentation among patients with GI symptoms, 32.4% had mild disease, 27.5% had moderate disease, and 40.1% had severe disease. The prevalence of digestive manifestations was 47%, and the main digestive manifestations were nausea (27%), diarrhea (17.1%), abdominal pain (17.1%) and vomiting (14.4%). GI symptoms such as abdominal pain, diarrhea, and vomiting were more common in those with hypertension (45%) and those with diabetes (43%). Conclusion: Gastrointestinal

关键词： COVID-19 Gastrointestinal Symptoms Senegal

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Hepatic Artery Aneurysm: An Unusual Cause of Upper Gastrointestinal Bleed in 49 Years Old Patient

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Open Journal of Gastroenterology 2022年第3期12卷 64-70页

作者： Salamata Diallo alioun. badara fall Mamadou Lamine Gueye Marie Louise Bassene Mamadou Ngoné Gueye Marieme Polele fall Mame Aissé Thioubou Alsine Yauck Department of Gastroenterology and Hepatology Hospital Aristide Le Dantec Dakar Senegal Department of General Surgery Hospital Aristide Le Dantec Dakar Senegal Department of Gastroenterology and Hepatology Hospital Idrissa Pouye Dakar Senegal Department of Gastroenterology and Hepatology Peace Hospital Ziguinchor Senegal

Hepatic artery aneurysm (HAA) is a rare disease. HAA is generally asymptomatic disease when symptomatic, they usually present with abdominal pain, upper gastrointestinal (GI) bleeding and/or jaundice, hypovolaemia secondary to rupture or GI bleeding with normal GI endoscopy. Surgical repair and endovascular treatment are the two therapeutic options available at present. Case report: A 49-year-old male presented at the emergency department with high gastrointestinal bleeding, abdominal pain and jaundice. Gastroscopy showed an ulcer with flat pigmented haematin on ulcer base (Forrest IIc) that was controlled by medical treatment. CT angiography was done and showed aneurysm of the proper hepatic artery almost totally thrombosed measuring 100 × 59 mm associated with signs of contained rupture. Emergency surgery was indicated. The laparotomy objectified a rupture of the aneurysm in the biliary tree in per operative excision of aneurysm and ligation of the hepatic pedicle was carried out. After surgery, the evolution was favorable with a follow-up of 8 months. Conclusion: HAA rupture is a rare cause of upper GI bleeding. The mortality rate after rupture is relatively high. CT angiography or MRI can diagnose a ruptured of HAA. Urgent surgery should be the first choice in patients with a ruptured HAA with active hemorrhage causing hemorrhagic shock.

关键词： Hepatic Artery Aneurysm Rupture Upper GI Bleeding Surgery

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Hepatitis C: Epidemiological, Clinical and Therapeutic Aspects in Dakar (Senegal)

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Open Journal of Gastroenterology 2022年第4期12卷 98-106页

作者： Salamata Diallo Mariéme Polele fall Marie Louise Bassène Mamadou Ngoné Gueye Mame Aissé Thioubou Cheikh Ahmadou Bamba Cissé alioun. badara fall Abdoul Aziz Atteib fall Alsine Yauck Cheikh Anta Diop University of Dakar Hospital Aristide Le Dantec Dakar Senegal Cheikh Anta Diop University of Dakar Hospital Idrissa Pouye Dakar Senegal Assane Seck University of Ziguinchor Hospital de la Paix Ziguinchor Senegal

Viral hepatitis C is a major public health problem. The aim of our work was to determine the epidemiological, diagnostic and treatment profiles of patients with HCV in Dakar (Senegal). We conducted a retrospective, descriptive, multicentre study between January 1, 2010, and December 31, 2019. We included 26 patients. The mean age of the patients was 53.5 years [28 - 70 years] and 46.2% were males. Of the 26 patients included, 7 (26.9%) were Senegalese, and the majority were from other African countries. Risk factors for contamination found were surgery in 11 patients (42.3%) and blood transfusion in 1 patient (3.8%). The mean viral load was 6.47 log IU/ml [4.26 - 7.26 log IU/ml]. Ten patients were infected by genotype 4. No patients were co-infected with HIV or HBV. Six patients (23.1% of patients) had significant fibrosis, of which five (19.2% of patients) were in the stage of cirrhosis. Twelve patients (46.2%) started treatment. Eleven were treatment-naïve and 1 did not respond to ribavirin-pegylated interferon-based therapy after 48 weeks. Ten cases of antiviral therapy were based on DAA and ribavirin-pegylated interferon in 2 patients. For the patients treated with peginterferon and ribavirin, a rapid virologic response was observed at 12 weeks in one patient, and the other patient was lost to follow-up. Among DAA-treated patients, 7 had sustained virologic responses at 12 weeks, 2 persisted, and 1 was lost to follow-up. Moderate thrombocytopenia and weight loss were observed in one patient receiving peginterferon and ribavirin. In our study, no patient died on treatment and no patients developed de novo HCC during or after DAA therapy. Conclusion: Viral hepatitis C is rare in Senegal. Despite the progress made in the therapeutic management of viral hepatitis C, it remains a challenge in Senegal. Indeed, DAAs are expensive and are not marketed, which makes them inaccessible to most patients.

关键词： Hepatitis C Epidemiology Diagnosis Treatment Senegal

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Acute Pancreatitis during SARS CoV 2 Infection

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Open Journal of Gastroenterology 2023年第1期13卷 28-32页

作者： Marie Louise Bassène Marième Poléle fall alioun. badara fall Salamata Diallo Coumba Kouba Cissé Téné Sidibé Aï ssé Thioubou Mamadou Ngoné Gueye Hô pital Aristide Le Dantec Avenue Pasteur Dakar Sénégal Hô pital de la Paix Ziguinchor Sénégal Hô pital Général Idrissa Pouye Dakar Sénégal

Introduction: Covid-19 is a systemic disease that can spread to all systems. Among the gastrointestinal manifestations, pancreatic involvement can have a major prognostic impact. We report 3 acute pancreatitis cases occurring during Covid-19, in Dakar. Case 1: 65-year-old woman who presented with intense atypical epigastric pain. Physical examination revealed obesity, high blood pressure and abdominal tenderness. Biological tests found increase CRP (134 mg/l) and lipasemia (312 UI/l). Abdominal CT scan showed findings of Balthazar grade C acute pancreatitis. RT-PCR for SARS CoV 2 RT-PCR was positive. The outcome was favorable. Case 2: 56-year-old woman patient with history of nephroangiosclerosis who presented with dyspnea, cough, fever and moderate epigastric pain. Physical examination revealed epigastric tenderness, high blood pressure, anuria. Biological testing, noted increase CRP (96 mg/l), lipasemia (793 UI/l), creatinine (227 mg/l) and urea (3.84 g/l). Abdominal CT scan showed acute edematous pancreatitis findings. SARS CoV 2 RT PCR was positive. The outcome was favorable. Case 3: 27-year-old man who presented with physical asthenia, headache, and epigastric pain. Physical examination found epigastric tenderness. Elevated CRP level was of 102 mg/l and lipasemia level was of 427 UI/l (7N). Abdominal CT scan showed acute edematous pancreatitis findings. SARS CoV 2 RT PCR was positive. The outcome was favorable. Conclusion: Acute pancreatitis can occur during Covid-19 infection. However, the imputability to the Covid-19 disease necessitates to rule out the most common causes.

关键词： Acute Pancreatitis SARS CoV 2 Covid-19

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A New Observation of Bone Marrow Involvement by Diffuse Large B-Cell Lymphoma Mimicking Myelofibrosis

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Open Journal of Blood Diseases 2022年第2期12卷 39-44页

作者： fall Seynabou alioun. badara Diallo Dibor Niang El Hadji Daouda Niang Khadim Sarr Marième Lolita Camara Abibatou Sall Fatou Samba Ndiaye Department of Hematology Cheikh Anta Diop University Dakar Senegal Department of Pathology Gaston Berger University Saint-Louis Senegal

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, characterized by high clinical and biological heterogeneity. Patients typically present with progressive lymphadenopathy, extranodal disease and may also experience fever, night sweats and unexplained weight loss. We report here the case of a 16-year-old female with osteoarticular pain, dizziness, and dyspnea on exertion. Clinical examination showed no lymphadenopathy. Complete blood count (CBC) revealed pancytopenia and marrow smears found to be hypocellular. Initial diagnosis favored secondary myelofibrosis. Diagnosis of bone marrow involvement by DLBCL was retained on bone marrow histology and immunohistochemistry which showed infiltration of large B lymphoid cells. The patient was treated by immunochemotherapy R-CHOP regimen. This case highlights a very rare and atypical circumstance of discovery of DLBCL with myelofibrosis as an initial symptom. Prognosis value of this presentation and management difficulties are also discussed.

关键词： Diffuse Large B-Cell Lymphoma Myelofibrosis Rituximab

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