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Descriptive and Analytical Study of Factors Associated with Mortality in Severe Malaria among Children in Dakar Emergency Departments from July to December 2022

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Open Journal of Pediatrics 2023年第6期13卷 866-878页

作者： Aliou Thiongane Abou Ba Fatou Ly Aliou A. Ndongo Djibril Boiro Younoussa Kéita Idrissa Basse Babacar Niang Indou Dême Ly Yaye Joor Dieng Djenaba Fafa Cissé Ndiogou Seck Lamine thiam Papa Moctar Faye Amadou Lamine Fall Assane Sylla Ousmane Ndiaye Centre Hospitalier National d’Enfants Albert Royer Dakar Sénégal Service de pédiatrie Hô pital Dalal Jamm Dakar Sénégal Service de pédiatrie Hô pital Pikine Dakar Sénégal Service de pédiatrie Hô pital Abass Ndao Dakar Sénégal Centre Hospitalier National d’Enfants de Diamniadio Dakar Sénégal Service de pédiatrie Hô pital régional Saint Louis Sénégal Service de pédiatrie Hô pital de la paix de Ziguinchor Ziguinchor Sénégal

Background: Malaria is the most widespread parasitic disease and remains a public health priority worldwide. The severe form is fatal if not treated early and appropriately. The aim was to carry out a descriptive and analytical study of the factors associated with mortality during severe malaria in children attending emergency departments in Dakar, Senegal. Methods: This is a prospective, observational and analytical study conducted over a 6-month period (July 1 to December 31, 2022), focusing on children hospitalized for severe malaria according to WHO severity criteria. Results: A total of 403 patients were hospitalized, including 78 cases of severe malaria (19.35%). Males predominated (60.26%) (sex ratio 1.51). The average age was 6.56 years [8 months - 14 years], with the [5 - 10 years] age group the most represented (40.26%). The average consultation time was 5.33 days (1 - 19 days). The main reasons for consultation were fever (70.51%), vomiting (24.35%) and convulsions (14.10%). Biological signs of severity were severe anemia (17.95%), renal failure (6.4%) and hypoglycemia (3.85%). Thrombocytopenia was noted in 52.56% of patients, including 32.05% of severe cases (sis in 61.41% of cases. Hyponatremia was noted in 39.74% of cases and hyperkalemia in 2 patients. Artesunate was the main drug used (93.59% of cases). Mortality was estimated at 1.5%. Factors leading to death were coma (P < 0.01), respiratory distress (P Conclusion: Malaria is still a public health problem, with a high mortality rate in emergency departments. Reducing this mortality rate requires effective management of the factors associated with death.

关键词： Children Malaria Death Factors

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相火理论的源流及应用规律探讨

相火理论的源流及应用规律探讨

作者：许添发（KOH thiam HUAT）广州中医药大学

学位级别：硕士

目的:中医学的发展最早可追溯到远古时期,其理论成果、临床实践可见一斑。相火作为早期的理论产物被历代各大名家不断丰富之下,相火及其相关理论有着更为深刻、广阔的内涵。就在各位医家扩充的过程,百家争鸣,各自赋予其具有个人的特色... 详细信息

目的:中医学的发展最早可追溯到远古时期,其理论成果、临床实践可见一斑。相火作为早期的理论产物被历代各大名家不断丰富之下,相火及其相关理论有着更为深刻、广阔的内涵。就在各位医家扩充的过程,百家争鸣,各自赋予其具有个人的特色的理论和涵义。因此,本课题的目的就是通过对相火的相关文献进行探讨,对相火的源流进行系统的梳理,总结归纳相火的根源、流支以及其相关理论的发展与运用,以期能更好地指导临床实践。方法:本文以时间为线索,以古今关于相火、其相关理论以及与临床各科的联系的各类文献为研究主体,采用历史学研究方法、发生学研究方法、文献学研究方法以及逻辑学研究方法,进行系统地整理、分析、归纳、总结。从“相火”的出现,再到代表医家对其的见解,从共性到个性,从联系到区别,试图对相火进行探讨,总结相火的演变与传承之路,进而对其源流有更为系统、深刻的认识与了解,对临床有着更进一步的指导意义。结果:1.相火之“源”:“相火”最早见于《黄帝内经》,“相火理论”始于金代医家刘完素。2.相火之“流”:金元时期为相火理论的鼎盛时期,朱丹溪从理学角度论述相火的生理与病理变化,此时相火理论体系已基本完善,张景岳认为君相皆为人体正气,相火源于命门。明清时期李时珍与赵献可等人对朱丹溪的相火理论进行发展,对临床应用进行补充说明。3.相火理论的核心内涵:相火由元气化生,由命门所主,寄居于肝肾,以心包络为充,以三焦为通道,起到温养全身脏腑、四肢百骸、经络诸窍的作用,促进推动人体生命的正常有序进行。4.相火理论的应用规律:相火理论用于疾病论治可分为外感相火疾病与内伤相火疾病两大类进行规律探讨。相火外感疾病多用正治之法,相火内伤疾病多用从治之法。结论:中医相火理论历经各朝各代医家,通过其临床实践、理论推理、归纳总结,形成了较为成熟的相火理论体系。本课题以时间为轴,一一呈现相火的起源、相火理论的发生、发展以及形成,并与临床实践相结合,展示相火理论子在临床各科的应用及其规律。初步较为系统地构建相火理论的框架体系,充分展现了相火理论的发展的深层规律。通过课题研究,对于探索中医相火理论的“源”与“流”,进一步完善了中医基础理论的基本体系,并且对于临床实践的指导有着更深刻的意义。

关键词：相火源流应用规律探讨

Study of Factor Associated with Post Stroke Depression in the Teaching Hospital of Fann (Dakar-Senegal)

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Health 2019年第11期11卷 1518-1528页

作者： Abou Sy Jean Augustin Diegane Tine Aissatou Diallo Ngor Side Diagne Kamadore Toure Ibrahima Seck Mamadouhabib thiam Department Psychiatry University Cheikh Anta DIOP Dakar Senegal Department Public Health University Cheikh Anta DIOP Dakar Senegal Department Neurology University Cheikh Anta DIOP Dakar Senegal Department Public Health University of Thies Thies Senegal

Introduction: Strokes are becoming more common in Africa, they are often accompanied by depressive symptoms, hence the need to investigate the factors associated with it for better management and prevention. Methodology: We conducted a prospective cross-sectional study amongst patients hospitalized with stroke at the Neurology/Neuroscience Clinic of the FANN UNHC (Dakar) in 2016. After a clinical diagnosis, patients are subjected to socio-demographic questionnaire and were administered with modified Rankin and MADRS scores. Results: Among the patients, 33.7% had Post-Stroke Depression, most were aged 50 to 70 years, male and married. History of stroke and depression was strongly associated with Post-Stroke Depression, while functional or cognitive impairment caused by stroke contributed to the development of Post Stroke depression. The type of ischemic or haemorrhagic stroke did not appear to affect the occurrence of the Post-Stroke Depression, but Post-Stroke Depression was more frequent in subjects with a left hemispheric lesion 47.8% (p Discussion: The occurrence of a Post-Stroke Depression is a factor of poor prognosis, early diagnosis and holistic care lead to improved quality of life.

关键词： Factor Depression Stroke Dakar

Conformational Radiotherapy of Prostatic Adenocarcinoma at the Dalal Jamm Hospital, Senegal—(Retrospective Analysis of a Series of 62 Cases)

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Journal of Cancer Therapy 2020年第10期11卷 631-638页

作者： Mouhamadou Bachir Ba Amadou Ibra Diallo Fatimatou Néné Sarr El Hadji Aliou Baldé Ibrahima thiam Papa Macoumba Gaye Radiotherapy Department Dalal Jamm Hospital UCAD Dakar Senegal Preventive Medicine and Public Health Service Health and Development Institute UCAD Dakar Senegal

Aim: We endeavored to describe the epidemiological profile of prostatic cancer, and to evaluate its diagnostic and therapeutic aspects. Method: We conducted a descriptive retrospective study on the conformational radiotherapy of prostatic adenocarcinoma at the Dalal Jamm University Hospital, Senegal from June 2018 to December 2019. We included 62 consecutive patients. The average age of the patients was 68.9 years. The average consultation time was 7.6 months. Results: Symptom manifestation and high PSA triggered the diagnosis of cancer in 74.2% and 25.8% of patients, respectively. Symptoms: pollakiuria (72.3%), bone pain (8%) and erectile dysfunction (4.8%). The digital rectal examination: normal (33.8%), nodular (30.6%), induration (24.1%), and shielding (11.3%). The mean PSA level was 90.6 ng/ml. Histology: adenocarcinoma was the most common (98.6%). The Gleason score: 7 (19.4%). The majority of patients were in the high-risk group (70.9%) and 7 patients (11.2%) were metastatic at diagnosis. Therapy: first radical prostatectomy (20.9%), first-line curative radiotherapy (67.8%), adjuvant (21%) and palliative radiotherapy in 7 patients (11.2%): patients having received palliative radiotherapy had an estimated decline in symptoms of 80%. Hormone therapy was performed in 88.8% of patients, with average duration of 12.5 months. After a mean follow-up of 15 months, 59 patients were alive, including 45 cases (81.8%) in complete remission;3 patients with metastasis at the first visit (having received palliative radiotherapy) died. Conclusion:

Sudden Cardiac Death in Dakar: Epidemiological and Anatomo-Pathological Characteristics

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Forensic Medicine and Anatomy Research 2019年第3期7卷 51-61页

作者： El Hadji Oumar Ndoye Amadou Mouctar Diallo Ibou thiam Mouhamed Manibiliot Soumah Sidy Ahmed Dia Mor Ndiaye Forensic and Labor Medicine Department Cheikh Anta Diop Dakar University (UCAD) Dakar Senegal Forensic Department Ignace Deen Hospital Conakry Guinea

Sudden cardiac death (SCD) generally refers to sudden cardiovascular death of a person with or without pre-existing heart disease. This is a retrospective study conducted at the Department of Anatomy and Pathological Cytology at Aristide Le Dantec Hospital in Senegal. This study covers a period of 7 years from January 1st, 2000 to December 31st, 2006. During this 7-year period we collected 235 cases of sudden cardiovascular death out of a total of 3717 forensic autopsies, representing a frequency of 6.32%. Sudden cardiovascular deaths accounted for 75.3% of all 312 sudden deaths. 96.1% were black compared to 3.9% Caucasians. The average age of the patients was 46.86 years with extremes ranging from 17 to 86 years. The most affected age group was between 50 - 59 years old, representing 23.4% of the cases. The sex ratio was 4.3 in favour of men. Men aged 50 - 59 were the most affected, while women were more affected in the 20 - 29 age group. Cardiomyopathies constituted 54.9% with 90% of dilated cardiomyopathies of which 75% were male and 10% of hypertrophic cardiomyopathies more frequent also in men. Valvulopathies came in 3rd position with 3.4% of the cases and in 75% of the cases they were poly-valvulopathies. Atherosclerosis was incriminated in 2.5% of the cases and aortic localization was the most represented. Aortic dissection was implicated in 6 cases out of 235 or 2.5%. It was isolated in 4 cases (without other cardiac conditions), and in the other 2 cases it was accompanied by other cardiac lesions including hypertrophy, pericarditis and endocarditis. The other causes found were interauricular communication (n = 1) and pericarditis (n = 2). Sudden cardiovascular death is a major global public health problem. The lack of epidemiological data on sudden death in Africa motivated our work, which led us to note that 75.3% of all sudden deaths in adults were of cardiovascular origin.

关键词： Sudden Cardiac Death Forensic Medicine Autopsy

Impact of Multifidus Muscle Morphometry on the Clinical Evolution of Chronic Low Back Pain

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Forensic Medicine and Anatomy Research 2023年第1期11卷 1-13页

作者： Ndèye Bigué Mar Aïnina Ndiaye Abdoulaye Ndoye Diop Gor Side Diagne Babacar Diao Souleymane Diao Racky Wade Issa Dior Seck Karim Yacouba Garba Sokhna Astou Gawane thiam Mamadou Ndiaye Magaye Gaye Magatte Gaye Sakho Jean Marc Ndiaga Ndoye Mamadou Diop Assane Ndiaye Abdoulaye Ndiaye Anatomy Laboratory/Joint Research and Diagnosis Unit Iba Der THIAM University of Thiès Thiès Senegal Laboratory and Organogen of Anatomy Cheikh Anta Diop University of Dakar Dakar Senegal Department of Radiology and Medical Imaging Gaston Berger University of Saint Louis Dakar Senegal Neurology Department Fann Hospital in Dakar Dakar Senegal Urology Service Ouakam Military Hospital Dakar Senegal Orthopedic Traumatology Service Idrissa Pouye Hospital of Grand Yoff-Dakar Dakar Senegal Neurosurgery Department Idrissa Pouye Hospital of Grand Yoff Dakar Senegal Anatomy Laboratory Assane Seck University of Ziguinchor Ziguinchor Senegal

Purpose: The multifidus muscle is an important extensor muscle of the lumbar spine. It plays a major role in the stability and realization of axial rotation movements of the thoraco-lumbar spine. Its atrophy by fatty degeneration would be at the origin of the occurrence of chronic low back pain which constitutes a public health problem in Senegal. Taking into account its anatomy is essential for the etiopathogenic analysis and the treatment of low back pain. The purpose of our work was to investigate the impact of multifidus muscle morphometry on the anatomy-clinical evolution of low back pain. Material and method: this was a prospective study over a period of 30 months from November 2019 to May 2022. It involved 100 patients seen in the neurology department of Fann Hospital for chronic low back pain and who had already had a scanner falling within the criteria for low back pain. We used 3D Slicer, SPSS 20, Excel 2016 software to model and analyze the morphometric data of the multifidus muscle after physiotherapy and control lumbar scans. Results: The sex ratio was 2.23. The average age of the patients was 45 ± 7 years. On the initial CT scan, according to the Hadar classification, we noted a predominance of grade 2 with 56% in L5/S1, followed by grade 1 with 32% and grade 3 with 14%. In L4/L5, the majority of patients, 67%, had grade 1. A conflicting circumferential disc bulge with the roots predominating in L5/S1 was present in 94% of men (p-value = 0.02). Before physiotherapy, the average volume of the multifidus was 193 mm3 ± 39, after physiotherapy it was 203 mm3 ± 42 with a progression rate of 5.2%. Clinically, severe type pain had regressed from 86% before physiotherapy to 0% after physiotherapy (p-value = 0.03). Conclusion: Taking into account the morphometry of the multifidus is an essential element in the management of chronic low back pain.

关键词： Morphometry Multifidus Low Back Pain Physiotherapy

Management of Severe Acute Malnutrition in a Senegalese Paediatric Hospital

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Open Journal of Pediatrics 2021年第2期11卷 198-207页

作者： Ndiogou Seck Idrissa Basse Djibril Boiro Younoussa Keïta Lamine thiam Aliou Abdoulaye Ndongo Ndéye Rama Diagne-Gueye Service de péDiatrie Centre Hospitalier Régional de Saint-Louis Saint-Louis Sénégal Hô pital pour Enfants de Diamniadio Bargny Sénégal Service de péDiatrie Centre Hospitalier Abass Ndao Dakar Sénégal Service de péDiatrie Hô pital Aristide Ledantec Dakar Sénégal Service de PéDiatrie H&ocirc pital de la Paix Boucoutte Ziguinchor Sénégal

Malnutrition is a global health problem. It is very common in developing countries where it contributes to an increase in morbidity and mortality, especially among children under five years of age. The main objective of this study was to describe the management of severe acute malnutrition (SAM) in children six months to five years of age hospitalized at Diamniadio Children’s Hospital (DCH). This was an epidemiological, retrospective, descriptive and cross-sectional study of children aged six to 59 months hospitalized at DCH for SAM. The study took place over a 12-month period (from January 1, 2018 to December 31, 2018). During the study period, 67 children were admitted for SAM, representing a hospital prevalence of 8.4%. The majority (88%) children were less than 24 months old. Reasons for consultations were dominated by diarrhea (57.5%) vomiting (38.8%). Complications related to SAM were mainly: anaemia (74.6%), infections (85%) and severe acute dehydration (40.3%). Factors associated with SAM were young age (infants under 24 months of age), poverty, the first four children of a sibling, poor behaviour of food diversification. The average length of hospitalization was 12 days. The nutritional recovery rate was 73.1% and lethality was 3%. Conclusion: The prevention of malnutrition must involve the fight against poverty, an optimal and well-diversified diet, monitoring the nutritional status of children up to five years of age.

关键词： Severe Acute Malnutrition Children Complications Risk Factors Lethality

A Shoulder Mass Revealing a Metastatic Prostate Cancer

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Case Reports in Clinical Medicine 2021年第4期10卷 133-139页

作者： Kanta Ka Mohamed Jalloh Babacar Sine Oumar Gaye Awa Sadikh Badiane Ibrahima thiam Mamadou Moustapha Dieng Papa Macoumba Gaye Radiotherapy Department Centre Hospitalier National Universitaire Dalal Jamm Guédiawaye Senegal Urology Department H&ocirc pital Général Idrissa Pouye Grand Yoff Senegal Cheikh Anta Diop University Dakar Senegal Urology Department Centre Hospitalier Universitaire Aristide Le Dantec Dakar Senegal

Introduction: A shoulder mass revealing metastatic prostate cancer is very rare. We report a case of metastatic prostate cancer diagnosed on a shoulder mass and treated with analgesic radiotherapy and chemotherapy and androgen deprivation therapy (ADT). Observations: A 66 years old patient was referred for a painful right shoulder mass whose biopsy and pathological examination found a Gleason 8 (4 + 4) moderately differentiated adenocarcinoma. The PSA level was 508.52 ng/ml. The patient was treated with analgesic radiotherapy on the right shoulder and chemo-hormonal therapy. At 2 years follow-up, the disease was well controlled. Conclusion: A shoulder mass revealing metastatic prostate cancer is not common. Local treatment of the symptomatic metastasis while continuing chemotherapy and ADT improves the quality of life.

关键词： Shoulder Prostate Cancer Metastasis

Modeling and Optimization of Interaction between Small Coastal Pelagic Fish, their Biological Predators and Fishermen

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Open Journal of Optimization 2021年第1期10卷 13-27页

作者： Ibrahima Diedhiou Salimata Gueye Diagne Fambaye Ngom Sow Coumba Diallo Diop Ndiaga thiam Gabriel Birame Ndiaye Aissatou Fall Ndoye Gueye Cheikh Anta Diop University of Dakar (UCAD) Dakar Senegal Department of Mathematics and Computer Science (DMI) UCAD Dakar Senegal Oceanographic Research Center Dakar Thiaroye (CRODT) Dakar Senegal Direction of Maritime Fisheries (DPM) Dakar Senegal

Small coastal pelagic fish are one of the fish families most affected by sea fishing. This man-made phenomenon leads to an imbalance in the marine and coastal ecosystem and is one of the main causes of migration north and offshore of the ranges. We used the ordinary differential equations to model the interactions existing between small pelagic resources and fishermen. Modelling follows the same of the Lotka-Volterra equations with a difference in the number of variables. This study confirmed the instability of the marine ecosystem. The objective is first of all to model a system of three interacting individuals composed of two distinct types of predators and two types of prey, and then optimise this interaction with the aim of conserving biodiversity in the ecosystem under study. Determining the Jacobian matrix made it possible to calculate the reproduction rate basic (R0). The study of the strong connectedness has made it possible to reduce the number of variables without losing the objective of the study. A computer program implemented on the language computer python facilitated the visualisation of the results.

关键词： Small Coastal Pelagics Ordinary Differential Equations Modelling Optimisation Basic Reproduction Rate