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Superior Mesenteric Artery Syndrome, a Rare Complication of Severe Malnutrition: Two Cases from a Subsaharian Endocrinology Department

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Open Journal of Endocrine and Metabolic Diseases 2024年第4期14卷 87-93页

作者： Nafy Ndiaye Ngone Diaba Diack yakham Mohamed Leye Sokhna Awa Balla Sall moussa Gueye Mouhamed Fawaz Mouhamadou Moustapha Ndong Abdoulaye Leye Department of Internal Medecine and Endocrinology Teaching Hospital of Pikine Dakar Senegal

Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m2, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.

关键词： Superior Mesenteric Artery Syndrome Malnutrition Pikine

Early Prosthetic Valve Endocarditis with Mycobacterium Tuberculosis after Mitral Valve Replacement: A Case Report

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World Journal of Cardiovascular Surgery 2024年第3期14卷 33-40页

作者： Papa Amath Diagne Mory Camara Papa Ousmane Ba Momar Sokhna Diop moussa Samba Abdou Lahad Mbengue Jean Claude Ndiogou Dione Myriam Bizrane Marième Soda Mbaye moussa Seck Diop Toudiani Malam Kaka Papa Salmane Ba Papa Adama Dieng Amadou Gabriel Ciss Assane Ndiaye Cardiovascular and Thoracic Surgery Department FANN National University Hospital Dakar Senegal

Background: Tuberculous endocarditis is a rare but serious complication of heart valve replacement surgery. We report the case of a 24-year-old patient, who presented with tuberculous endocarditis after mechanical mitral valve replacement, with a favorable clinical course following anti-tuberculosis treatment. Case Presentation: We report a 24-year-old male patient, admitted to the cardiac surgery department of the Fann Hospital (Dakar, Senegal), for the management of severe mixed (rheumatic and endocarditic) mitral insufficiency with associated tricuspid insufficiency. He had a history of recurrent angina and polyarthralgia in childhood, was hospitalized several times for refractory global cardiac decompensation, and for a suspected infective endocarditis a month before his admission. On admission, the clinical examination revealed signs suggestive of mitral and tricuspid insufficiency. Transthoracic echocardiography revealed severe post-endocarditic mitral insufficiency with A3 amputation, highly mobile 15 mm vegetations on the free edge of the large valve, moderate tricuspid insufficiency, and severe pulmonary artery hypertension. Mechanical mitral valve replacement and tricuspid valve annuloplasty using autologous pericardial strip were performed via median sternotomy. After ten days, the patient presented with global cardiac decompensation associated with a clinico-biological infectious syndrome, and tans-oesophageal echography revealed an abscess at the sinotubular junction, communicating with the aorta. A thoraco-abdomino-pelvic CT scan was done, which revealed a bilateral alveolar-interstitial syndrome with mediastinal lymphadenopathy. Anti-tuberculosis treatment with RHZE was initiated for 06 months. The clinical course was favorable. Conclusion: Tuberculous endocarditis in prostheses is a serious complication of heart valve replacement surgery, which may evolve favorably under medical treatment.

关键词： Tuberculous Endocarditis Prosthetic Valve Endocarditis Mycobacterium Tuberculosis

Bilharzia Appendicitis: Incidence in a Commune in Mali, about 3CAS

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Surgical Science 2024年第5期15卷 321-329页

作者： Souleymane Bingue Dembélé yely Dianessy.moussa Samake Abdou Guiré Siaka Konaté Ousmane Sy Boubacar yoro Sidibé Amadou Maïga Thiorno Nadio Boubacar Karembe Amaguiré Saye Sirama Diarra Dorcas Sodjiné yede Issiaka Diarra Ibrahima Maiga Mahamane Dicko moussa Konaté Aliou Bina Diarra Bakary Tientigui Dembélé General Surgery Department of the District Hospital of Commune IV of Bamako Bamako Mali Kolondié ba Reference Health Centre Sikasso Mali Epidemiology and Clinical Research Bamako Mali General Surgery Department of Gabriel Touré University Hospital Bamako Mali Ophthalmology Department of the District Hospital of Commune IV of Bamako Bamako Mali Gynecology and Obstetrics Department of the District Hospital of Commune IV of Bamako Bamako Mali Commune I of the District of Bamako Reference Health Centre Bamako Mali Imaging Department of the District Hospital of Commune IV of Bamako Bamako Mali Commune VI of the District of Bamako Reference Health Centre Bamako Mali Anotomy-Pathology Department of the G Point University Hospital Bamako Mali

Appendicitis bilharzia is a very rare condition and we report 3 cases of this pathology that sense clinical and biological similarities with bacterial appendicitis. The etiological diagnosis was exclusively histopathological, this allowed to highlight eggs of Schistosome in the appendicular wall in the three patients. The surgical treatment was supplemented by a specific medical treatment based on praziquantel. The surgical suites were simple for 2 patients, complicated by superficial parietal suppuration in a patient.

关键词： Bilharzial Appendicitis Endemic Histopathology Specific Antiparasitic Treatment

Tuberculosis in the Carcinal Environment in Chad Due to the Mycobacterium Tuberculosis Circulante Complex

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Journal of Biosciences and Medicines 2024年第2期12卷 214-224页

作者： Ahmat Idriss Ahmat Mahamat Tahir Ngaré Hassan Ngandolo Bongo Nare Richard Mahamat Adanao Adoudou Mbah Ntepe Leonel Javeres Hamidou yacoubou Ali Mahamat moussa Laboratory for Diagnostic Research and Scientific Expertise University of N’Djamena N’Djamena Chad Veterinary and Zootechnical Research Laboratory of Farcha N’Djamena Livestock and Development Research Institute N’Djamena Chad Institute of Medical Research and Medicinal Plant Studies (IMPM) Ministry of Scientific Research and Innovation Yaoundé Cameroon Cameroon Ministry of Public Health Yaoundé Cameroon Faculty of Human Health Sciences University of N’Djamena N’Djamena Chad

Tuberculosis (TB) is a serious infectious disease and its control is considered a challenge, particularly among vulnerable populations such as prisoners. The prevalence of TB in prisons is an alarming public health problem in many countries. The aim of this study is to describe the epidemiology of tuberculosis and the strategies for controlling this disease in the Chadian prison population. During the course of our study, the prevalence of tuberculosis in prisons was 9.64%. The age group between 55 years and over (43.33%) was the most represented in this study, and all patients were men with a frequency of 62.66%. The cross-tabulation of Culture_7H9G and Culture_7H9P showed that out of our total positive sample, we found a total of 87 positive strains and 63 negative strains. Our study shows that it is essential to know the prevalence of tuberculosis in all the country’s prisons. Indeed, this can serve as an indication of the need for action in prisons to reduce TB rates, in particular by improving the structure of prison environments, diagnosing new cases quickly and accurately, identifying drug-resistant strains and implementing effective, direct treatment observed in people with tuberculosis.

关键词： Mycobacterium Prison Tuberculosis and Chad

Resistant Pulmonary TB-HIV Co-Infection in an Infant: About a Case

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Open Journal of Pediatrics 2024年第2期14卷 420-425页

作者： Mariam Maiga Pierre Togo Tati Simaga Mariam Traoré moussa Konaté Mamadou Diallo Alou Samaké Mamadou Keïta Korotoumou Wélé Diallo Djibril Kassogué Pediatrics Department Distric VI Reference Health Center Bamako Mali Paediatrics Department Gabriel Touré Teaching Hospital Bamako Mali Pediatrics Department Mali Hospital Bamako Mali Paediatrics Department Timbuktu Regional Hospital Bamako Mali

Diagnosis of childhood tuberculosis (TB) is difficult, especially in resource-limited countries where the number of reported cases of TB-HIV co-infection continues to rise. This co-infection poses a diagnostic and therapeutic problem for caregivers. We report a case of rifampicin-resistant HIV-TB pulmonary coinfection in a 19-month-old infant.

关键词： Tuberculosis Rifampicin Resistance HIV Infants

Isotope Tracking of Surface Water Groundwater Interaction in the Beninese Part of the Iullemeden Aquifer System

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Journal of Water Resource and Protection 2024年第7期16卷 489-501页

作者： Houégnon Géraud Vinel Gbewezoun Samuel yao Ganyaglo Abdoukarim Alassane Samuel Boakye Dampare Gaya Salifou Orou Pete Alou moussa Boukari Daouda Mama Laboratoire dHydrologie Applique (LHA) of Institut National de lEau (INE) Universit dAbomey-Calavi Abomey-Calavi Benin International Chair in Mathematical Physics and Applications (ICMPA-UNESCO Chair) Universit dAbomey-Calavi Abomey-Calavi Benin School of Nuclear and Allied Sciences (SNAS) University of Ghana-Atomic Campus Accra Ghana Ghana Atomic Energy Commission (GAEC) Accra Ghana

The Kandi basin is located in northeast Benin (West Africa). This study is focused on the estimation of water fluxes exchanged between the river Niger (and its tributaries) and the transboundary Iullemeden Aquifer System. In that framework, an innovative approach based on the application of the Bayesian Mixing Model (MixSIAR) analysis on water isotopes (oxygen-18, deuterium and tritium) was performed. Moreover, to assess the relevance of the model outputs, Pearson’s correlation and Principal Component Analysis (PCA) have been done. A complex relationship between surface water and groundwater has been found. Sixty percent (60%) of groundwater samples are made of more than 70% river water and rainwater;while 31.25% of surface water samples are made of about 84% groundwater. To safeguard sustainable water resources for the well-being of the local communities, surface water and groundwater must be managed as a unique component in the Kandi basin.

关键词： Benin West Africa Kandi basin Iullemeden Aquifer System Surface Water Groundwater Interaction

The Dental Absces: Epidemiological, Clinical and Therapeutic Aspects at the Dental Office of the Prefectoral Hospital of Siguiri in 2021 in the Republic of Guinea

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Open Journal of Stomatology 2024年第9期14卷 382-391页

作者： Magna Condé Aly Badara Nabé Fanta Madi Traoré moussa Doré Djibrila Camara Kaïn Condé Mory Sacko Francine Manto Kuete Kouamé Patrice Attogbain African Center of Excellence for the Prevention and Control of Communicable Diseases (CEA-PCMT) Faculty of Health Sciences and Techniques of the Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Odontology Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea Department of Odontology and Maxillofacial Surgery of the Ignace Deen National Hospital Conakry Guinea Department of Pathology and Therapeutics UFR Odonto-Stomatology Felix Houphouet Boigny University Abidjan Ivory Coast

Introduction: A dental abscess is a collection of pus located in the tissues surrounding the tooth roots. The aim of this work is to describe the epidemiological, clinical and therapeutic aspects of dental abscess in order to contribute to the management of patients suffering from this pathology at the dental office of the Siguiri Prefectural Hospital. Methods: This was a retrospective descriptive study lasting 2 months carried out on the registers of patients received between October 2017 and October 2020 at the dental office of the Siguiri prefectural hospital. Results: 4690 patient files were identified during the study, of which 546 met our selection criteria, i.e. a frequency of 11.64%. During our study, we found 51.83% female compared to 48.17% male, i.e. a sex ratio of 1.07. 54.21% of our patients resided in rural communes compared to 45.76% for the urban commune. The age group most affected was that of 16 - 25 years old or 33.69%. Swelling, pain and functional discomfort were the reasons for consultation in all patients followed by other associated reasons in 41.21%. The premolar-molar group was the most represented, i.e. 86.70%. 80.04% of our patients presented an acute abscess compared to 19.96% of chronic cases. Antibiotic, analgesic, and mouthwash were prescribed in all patients during the study followed by 96.37% of cases prescription of steroidal anti-inflammatory drugs. 93.04% of causal teeth were extracted followed by 6.78% of cases of conservative treatment in our study. In our study, 80.95% of our patients had a good post-therapeutic outcome. Conclusion: This study highlights the need for prevention and early management of dental abscesses.

关键词： Dental Abscess Epidemiological Clinical Therapeutic

Management of Acute Idiopthic Intestinal Invaginal in Infants at Conakry University Hospital

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Open Journal of Pediatrics 2024年第5期14卷 937-950页

作者： Thierno Saidou Barry Mohamed Lamine Sadou Sacko Balla Keita Mory Sangare Fanta Kourouma moussa Conde Baldé Aissatou Bailo Seydou Keita Daniel Agbo-Panzo Pediatric Surgery Department of the Conakry University Hospital Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea Pediatrics Department Albert Royer Childrens Hospital Cheikh Anta Diop University of Dakar (UCAD) Dakar Senegal General Surgery Department of the Ignace Deen University Hospital Conakry Guinea

Introduction: Acute intestinal intussusception (AII) has been known for a long time but its diagnosis sometimes remains difficult and its etiologies, particularly the idiopathic forms, poorly elucidated. The objective of this study was to describe the clinical and therapeutic aspects of acute intestinal intussusception in order to contribute to the improvement of the management of this condition in the pediatric surgery department of the Donka National Hospital. Materials and Methods: This is a retrospective descriptive study of patients taken in charge of acute idiopathic intestinal intussusception over a period of 7 years (January 2017 to December 31, 2023). Results: We collected 72 patients operated on for IIA, i.e. a hospital frequency of 1.1% and an incidence of 10.3 cases per year. The mean age was 16.58 months with extremes of 3 months and 28 months. The sex ratio was 12.5 in favor of the boy. The triad of ombredanne dominated the clinical picture and paroxysmal abdominal pain with period of calm represented the main reason for consultation (72 cases) i.e. 100%, followed by vomiting (62 cases) and rectal bleeding (50 cases). Ultrasound was performed in 56 patients visualizing the intussusception sausage in 54 patients or 75%. The most common anatomoclinical variety of intussusception was the ileo-caeco-colic form with 35 cases (or 38%) followed by the ileocolic form 24 cases (33%). The surgical procedure performed was a manual reduction in 54 patients or 75% and an anastomosis resection in 18 patients;the appendectomy of principle was done in 62.25%. The postoperative course was simple in 64 patients or 88.88%. The mortality rate was 6.94 %. Conclusion: AII is a common abdominal surgical emergency in infants. Recognition of the Ombredanne triad especially abdominal pain with a period of calm in children and infants in particular is an important element for vital prognosis. Early diagnosis and close interdisciplinary cooperation between pediatric, radiology an

关键词： Acute Idiopathic Intussusception Infant Intussusception Sausage Pediatric Surgery

Evaluation of the Strategy and Efficacy of Treatment of Chronic Viral Hepatitis C with the Sofosbuvir/Daclatasvir Combination in a Resource-Limited Country

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Open Journal of Gastroenterology 2024年第7期14卷 233-240页

作者： Mayanna Habkreo Ali Mahamat moussa Adama Ahmed Ngare Abdraman Kossou Tahir Mahamat Saleh Maire Dehainsala Mahamat Ali Hachim Mahamat Ali Bolti Oumaima Djarma Joseph Madtoingue Service de Gastroentrologie/Mdecine Interne du Centre Hospitalier Universitaire la Rfrence Nationale NDjamena Chad Service de Gastroentrologie du Centre Hospitalier Universitaire la Renaissance NDjamena Chad Service de Maladies Infectieuses du Centre Hospitalier Universitaire la Renaissance NDjamena Chad Service de Maladies Infectieuses du Centre Hospitalier Universitaire la Rfrence Nationale NDjamena Chad

Introduction: The treatment of viral hepatitis C (HCV), a major public health problem, has evolved considerably since the introduction of direct-acting anti-virals (DAAs). The aim of this study was to evaluate the strategy for initiating treatment with Sofosbuvir/Daclatasvir, and also to assess its efficacy. Patients and Methods: Included were patients aged at least 15 years, with detectable hepatitis C viremia and treated with a pan-genotypic Sofosbuvir/Daclatasvir regimen at the Centre “Hospitalier Universitaire la Référence Nationale de N’Djamena” between October 2019 and October 2023. The APRI score was used to assess fibrosis. Cure was defined by an undetectable viral load 12 weeks after the end of treatment. Results: A total of 835 patients were included (sex ratio 1.55, mean age 50.5 ± 13.73, extremes 20 and 84 years). The 60 - 69 age group was the most represented. The mean APRI score was 0.42 ± 0.29, with extremes of 0.019 and 1.84. The mean viral load was 2,316,193.086 IU/mL. All subjects had good renal function. Cytolysis was absent in 70% of cases. Without genotyping, a pan-genotypic regimen was used in all patients: Sofosbuvir (400 mg)/Daclatasvir (60 mg). The cure rate was 99.4%, with good tolerability. However, four cases of failure were recorded out of the 668 patients who underwent follow-up HCV-PCR testing after 12 weeks of treatment. Conclusion: The Sofosbuvir/Daclatasvir regimen is highly effective, with an excellent safety profile. However, the still high cost of these molecules limits their accessibility to a large proportion of patients.

关键词： Efficacy Tolerance Sofosbuvir/Daclatasvir HCV Chad