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Idiopathic Adult Nephrotic Syndrome: A Clinicopathological Study and Response to Steroid in a Sub-Saharan African Country

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Open Journal of Nephrology 2016年第2期6卷 61-65页

作者： Maria Faye Ahmed Tall Lemrabott Mouhamadou Moustapha Cisse Jean De Dieu Nzambaza cherif mouhamed dia Sidy Mohamed Seck Khodia Fall Moustapha Faye Elhadji Fary Ka Abdou Niang Boucar Diouf Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Anatomo-Pathology Laboratory Grand-Yoff General Hospital Dakar Senegal Faculty of Medicine Gaston Berger University Saint-Louis Senegal

Introduction: Idiopathic nephrotic syndrome represents 25% to 30% of glomerulonephritis in adults. These glomerulonephritides are responsible of about the half of chronic kidney failure examined as well in United States as in Europe or Africa. The aim of this study was to determine the anatomoclinic, therapeutic and progression patterns of idiopathic nephritic syndrome in Dakar. Patients and Methods: It is a retrospective ten-year study in the nephrology department of Aristide Le Dantec Hospital. Patients with idiopathic nephrotic syndrome were included. We analyzed anatomoclinic, therapeutic and progression data of idiopathic nephrotic syndrome. Results: On 202 patients with nephrotic syndrome, 156 (77%) were primitive. The mean age was 29.7 ± 12 years with a sex ratio of 2.4. Edema was found in 98 patients (62.8%) and hypertension in 63 patients (40%). The mean proteinuria was 6.8 ± 4.8 g/24h. Histologic lesions found at renal biopsy were focal segmental glomerulosclerosis in 71 patients (45.5%), minimal change disease in 68 patients (43.5%) and membranous nephropathy in 8 patients (5%). 134 patients (85.8%) received steroids alone, 12 patients (7.6%) received cyclophosphamide and 4 patients (2.5%) azathioprine in association with steroids. 44 patients (28.2%) reached remission. The factors of poor prognosis were: age, above 40 years, proteinuria above 10 g/24h, existence of renal failure at admission, absence of use of steroids therapy. Conclusion: This study shows that idiopathic nephrotic syndrome is frequent in our country with a prevalence of 77%. The most common lesion found at the renal biopsy is the focal segmental glomerulosclerosis. Remission is found only in 28% which is very low. 33% of patients progress towards chronic kidney disease due to the lack of early diagnosis and the use of traditional medicine.

关键词： Idiopathic Nephrotic Syndrome Focal Segmental Glomerulosclerosis Minimal Change Disease Membranous Glomerulonephritis

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Double Compression of Left Atrium and Pulmonary Artery by a Huge Descending Aortic Aneurysm with Intramural Hematoma Mimicking Pulmonary Embolism: A Case Report

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World Journal of Cardiovascular Diseases 2019年第6期9卷 419-424页

作者： Djibril Marie BA Aminata diack Alain Affangla Khadidiatou dia mouhamed cherif Mboup mouhamed Leye Abdoul Kane Unit of Training and Research in Medical Sciences University of Thies Thies Senegal Department of Radiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Cheikh Anta Diop University Dakar Senegal

Hemodynamic instability secondary to left atrial (LA) compression by an aortic aneurysm is a rare entity. We report?the case of a 43-year old woman with no previous diagnosis of congestive heart failure who was admitted for an initial diagnosis of pulmonary embolism (PE) based on shortness of breath, hypotension and D-Dimers?elevation. The electrocardiogram and blood counts were within normal limits. The chest X-ray revealed widening of the mediastinum. Transthoracic echocardiography demonstrated LA compression by a large descending thoracic aortic aneurysm. Left and right ventricle systolic functions were preserved. Chest angiography showed LA and left pulmonary artery (LPA) compression by a descending aortic aneurysm and an intramural hematoma with no evidence of PE evidence. Emergency surgery could not be done because of her financial status. She was treated medically and was discharged 1?week later with significant improvement. However she remained hypotensive.

关键词： Aortic Aneurysm Left Atrium Compression Pulmonary Artery Compression Intramural Hematoma Echocardiography

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Late diagnosis of Takayasu Disease in a 50-Year-Old African Black Woman with Repeated Episodes of Heart Failure: Seeing the Forest through the Trees—A Case Report

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World Journal of Cardiovascular Diseases 2020年第10期10卷 683-697页

作者： Djibril Marie BA Aminata diack Alain Affangla Serigne Cheikh Tidiane Ndao Madjiguene KA Khadidiatou dia mouhamed cherif Mboup mouhamed Leye Unit of Research and Training in Medical Sciences University of Thies Thies Senegal Department of Radiology Principal Hospital of Dakar Dakar Senegal Department of Cardiology Principal Hospital of Dakar Dakar Senegal

Background: First described in 1908, TAK has now been recognized as a non-specific inflammatory disease of unknown etiology, predominantly affecting young females. Sometimes, it progresses into relatively rare and potentially fatal scenarios such heart failure. Case Presentation: Here, we present the case of a 50-year sub-saharan female suffering from acute heart failure related to TAK. Despite constitutional symptoms (fever, malaise, weight loss) and more characteristic features such claudication of lower extremities, carotydinia, and pulseless syndrome, diagnosis of TAK was delayed since main presentation was heart failure. Immunosuppressive and anticoagulant therapies have induced improvement in cardiac manifestations. Conclusion: Early diagnosis and proper treatment can protect the patient from dangerous complications such heart failure.

关键词： Takayasu Heart Failure Corticotherapy Pulseless Syndrome Sub-Saharan Black Female Case Report

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Coronary Angioplasty in a Low Income Sub-Saharan Country: Situational Analysis

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World Journal of Cardiovascular Diseases 2018年第12期8卷 539-544页

作者： mouhamed cherif Mboup Djibril Marie Ba Modou Jobe Massamba Thiam Khadidiatou dia Pape diadie Fall Hopital Principal de Dakar Dakar Senegal Military Hospital of Ouakam Dakar Senegal Clinique Du Golf Dakar Senegal

Introduction: Coronary angioplasty is not widely conducted in sub-Saharan Africa in general and Senegal in particular. The objective of this work was to describe the indications, techniques, results and difficulties of coronary angioplasty in Senegal. Patients and Methods: We prospectively included all patients who underwent coronary angioplasty between July 2012 and November 2014. We evaluated the clinical characteristics, techniques used, and the peri-procedural complications. Results: 110 coronary angioplasties were performed at the cardiac catheterisation unit of the Clinique du Golf in Dakar. The average age of patients was 60.41 ± 10.93 years. A male predominance was noted with a sex ratio of 6.3. Hypertension was found in 57% of patients. The principal indications for coronary angioplasty were for the management of acute coronary syndromes with or without ST elevation, in 29 and 39 patients respectively. The femoral artery was the puncture site in 104 patients. The lesions treated were type A/B1 or B2/C in 53 and 57 cases respectively. The success rates of coronary angioplasties and 30-day mortality were 91% and 0.9% respectively. Conclusion: In sub-Saharan Africa, Senegal in particular, the practice of coronary angioplasty is low. Indeed, many factors linked to socioeconomic status limit the development of coronary angioplasty in Senegal.

关键词： Coronary Angioplasty Acute Coronary Syndrome Interventional Cardiology

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Inadvertent Lead Malposition in the Left Ventricle during Permanent Ventricular Pacing about One Case

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World Journal of Cardiovascular Diseases 2023年第11期13卷 756-763页

作者： Khadidiatou dia Waly Niang Mboup Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Rabab Yassine Djibril Marie Ba Demba Ware Balde mouhamed cherif Mboup Department of Cardiology Hospital Principal of Dakar Dakar Senegal Department of Cardiology Military Hospital of Ouakam Dakar Senegal

Inadvertent Lead Malposition in Left Ventricle is a rare and underdiagnosed incident, which may occur during implantation of cardiac electronic devices and may remain asymptomatic. We reported the case of a 71-year-old man who was implanted with a ventricular single-chamber pacemaker for a slow atrial fibrillation with syncope and whose routine transthoracic echocardiography 23 months after implantation displayed a malposition of the pacemaker lead into the Left Ventricle through a patent foramen oval. The patient was asymptomatic. The electrocardiogram showed right bundle branch block QRS-paced morphology with a positive QRS pattern in V1, a median paced QRS axis on the frontal plane at -120°, a Precordial transition on V5. At the lateral Chest X-ray the lead curved backwards to the spine. Given the age of this old patient who already received oral anticoagulant for Atrial Fibrillation and the Lead malposition discovered 23 months after pacemaker’s implantation, we decided to maintain the lead in LV and continue anticoagulation.

关键词： Lead Malposition Left Ventricle Lead Right Bundle Branch Block Ventricu-lar Pacing Transthoracic Echocardiography

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Pulmonary Embolism in Young Patients: About 24 Cases at the Cardiology Department of Dakar Principal Hospital in Senegal

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World Journal of Cardiovascular Diseases 2019年第9期9卷 632-638页

作者： Joseph Salvador Mingou Amadou Tidjani Saadou Madjiguene Ka Zoumana Sangaré Serigne Cheikh Tidiane Ndao Khadidiatou dia mouhamed cherif Mboup Pape diadié Fall Department of Cardiology Hospital Principal Dakar Senegal Departement of Cardiology Hospital Aristide Le Dantec Dakar Senegal

Introduction: Pulmonary embolism is a relatively common life-threatening cardiovascular emergency. It remains a diagnostic problem because of its nonspecific clinical signs. Objective: The general objective was to study pulmonary embolism in young patients admitted to the cardiology department of Dakar Principal Hospital in Senegal. Methodology: This was a retrospective, descriptive and analytical study in the cardiology department of the Dakar Principal Hospital over a period of two (02) years from January 1, 2015 to December 31, 2016 in young patients admitted for pulmonary embolism. Results: We collected 24 patients with a hospital prevalence of 2.18%. The average age was 42.29 years ± 8.41 years with a male predominance (sex ratio of 1.6). The Wells probability score was low in 54.16% of patients and medium in 45.83%. Functional signs were dominated by chest pain (83.33% of cases) followed by dyspnea (79.16% of cases). The thromboembolic risk factors found were gynecological-obstetrical in 16.6% of cases followed by prolonged bed rest. One case of thrombophilia was present with a deficiency of protein C and antithrombin III. The electrocardiogram recorded sinus tachycardia in 29.16% of patients;the Mac Ginn White sign (S1Q3T3) was found in 25% of cases. Echocardiography showed pulmonary arterial hypertension in 12.48% of cases, dilation of the right ventricle and a paradoxical septal motion in 14.28% of cases. CT pulmonary angiography showed 63.63% of cases with bilateral pulmonary embolism;it was unilateral in 22.72% of cases. Long-term anticoagulation was based on acenocoumarol 4 mg (66.7%) and Rivaroxaban (33.3%). 62.5% of the patients were seen at the 3rd month, when a checking was made to evaluate the tolerance of the treatment, and the evolution of the patient. Conclusion: Pulmonary embolism is not a rare condition in young subjects but is often underdiagnosed. Gyneco-obstetrical factors are predominant in this age group. Direct oral anticoagulants are mor

关键词： Pulmonary Embolism Young Patients Dakar (Senegal)

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Cardiac Resynchronization Therapy in Heart Failure in Sub-Saharan Africa Environment: Experience of the Principal Hospital of Dakar (Senegal)

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World Journal of Cardiovascular Diseases 2023年第7期13卷 349-358页

作者： Khadidiatou dia Waly Niang Mboup Djibril Marie Ba Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Rabab Yassine Demba Ware Balde mouhamed cherif Mboup Department of Cardiology Hospital Principal of Dakar Dakar Senegal Department of Cardiology Military Hospital of Ouakam Dakar Senegal

Background: Heart failure is a major public health challenge in sub-Saharan Africa. In patients with chronic Heart Failure and cardiac desynchrony, studies have suggested that cardiac resynchronization, can improve cardiac function and the quality of life of patients. However, in Sub-Saharan Africa, very few studies have been done on cardiac resynchronization which is in its infancy. The aim of this study is to report the local data from our hospital. Method: It was a transversal, descriptive and analytical study conducted from November 2019 to September 2022 at the Cardiology Department of the Principal Hospital of Dakar. Results: Twelve patients were implanted for Cardiac Resynchronization Therapy (CRT). The sex ratio was 8 males/4 females. The average age was 67 ± 11 years. Ten patients had non-ischemic heart disease and the two others had ischemic one. All of them had NYHA III or IV scores before CRT. The Quality of Life (QOL) was judged as poor by all of the patients. The average duration of QRS was 156 ± 9 ms. 27.9% ± 5% was the mean Left Ventricular ejection fraction (LVEF). Complications occur in 3/12 patients (25%). It was one CS vein dissection, one micro LV lead dislodgement and one phrenic nerve stimulation. Nine patients, who were considered as responders, had an improvement of QOL and NYHA, the LVEF increased and the end-diastolic dimension, and the duration of the QRS interval all decreased. Two patients do not respond and one (1) who had permanent atrial fibrillation, was a secondary responder after an atrioventricular junction ablation. Conclusion: Cardiac resynchronization is a therapy that improves the QOL of patients, the LVEF and reduces the duration of the QRS interval. However, this procedure is not without risk of complications. In sub-Saharan Africa, the major challenge is to improve the financial accessibility of this therapy for the population.

关键词： Cardiac Resynchronization Therapy CRT Heart Failure Biventricular Pacing Sub-Saharan Africa

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Atrial Fibrillation in Wolff Parkinson White Syndrome: About a Case in Senegal

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World Journal of Cardiovascular Diseases 2023年第1期13卷 1-6页

作者： Waly Niang Mboup Khadidiatou dia Mame Madjiguène Ka Serigne Cheikh Tidiane Ndao Demba Ware Balde Djibril Mari Ba mouhamed cherif Mboup Adama Kane Department of Cardiology Principal Hospital of Dakar (HPD) Dakar Senegal Department of Cardiology Military Hospital of Ouakam (HMO) Dakar Senegal Department of Cardiology Aristide Le Dantec University Hospital Center Dakar Senegal

WOLFF PARKINSON and WHITE (WPW) syndrome is the most common form of pre-excitation. It is associated in some cases with atrial fibrillation with a high risk of sudden death. We report the case of a 64-year-old hypertensive woman with a history of ischemic stroke. She presented with hyperkinetic palpitations without hemodynamics instability on admission. The electrocardiogram recorded a complete tachyarrhythmia by pre-excitation atrial fibrillation, with a mean rate of 300 beats per minute. Electrophysiological investigation revealed an accessory pathway located at the ostium of the coronary sinus, which was successfully ablated by radiofrequency. A drug treatment based on flecaine 100 mg was introduced. The patient was asymptomatic after one month of outpatient follow-up.

关键词： Wolff Parkinson and White Atrial Fibrillation Senegal

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Cardiovascular and Cerebrovascular Prognosis at 5 Years of Patients Who Presented with an Ischemic Stroke at Principal Hospital of Dakar

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World Journal of Cardiovascular Diseases 2022年第1期12卷 77-86页

作者： Waly Niang Mboup Mame Madjiguène Ka Serigne Cheikh Tidiane Ndao Demba Ware Balde Djibril Mari Ba Khadidiatou dia Pape diadji Fall mouhamed cherif Mboup Department of Cardiology Principal Hospital/Dakar (HPD) Dakar Senegal Department of Cardiology Military Hospital of Ouakam/Dakar (HMO) Dakar Senegal

Aims: To determine the cardiovascular and cerebrovascular prognosis at 5 years of patients who underwent an ischemic stroke in Senegal. Methods: We performed a descriptive, retrospective and exhaustive study conducted at Principal Hospital of Dakar. We included all patients hospitalized at Principal Hospital of Dakar from 2013 to 2019 for an ischemic stroke confirmed by a cerebral CT-Scanner or by magnetic resonance imaging, and who survived the acute phase. Results: Overall, one hundred and seventy-one (171) patients were gathered. Ninety-six (96) male patients account for 56.14% and seventy-five (75) female patients account for 43.86%, with a sex ratio of 1.28. Patients’mean age was 66.33 ±13.99 years. Twenty-one (21) young patients (12.35%), aged less than 50 years, presented with an ischemic stroke. Myocardial infarction was found in a female patient (0.6%) 3 months after she experienced an ischemic stroke, nine (9) patients (5.29%) underwent a recurrence of the ischemic stroke

关键词： Cardiovascular Cerebrovascular Prognosis Ischemic Stroke Dakar

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Connective Tissue Diseases on the Elderly Population in Dakar Hospital Setting

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Open Journal of Internal Medicine 2022年第2期12卷 103-111页

作者： Ndao Awa Cheikh Atoumane Faye Amadou Diop dia Nafissatou diagne diatou Gueye dia Birame Codou Fall Michel Assane Ndour mouhamed Dieng Maïmouna Sow Abdoulaye Pouye Department of Internal Medicine Aristide Le Dantec Hospital Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Regional Hospital of Saint-Louis Gaston Berger University Saint-Louis Senegal Department of Internal Medicine DalalJamm Hospital Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Abass Ndao Hospital Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Aristide Le Dantec Hospital Dakar Senegal

Introduction: Immunosenescence contributes to the development of auto-antibodies. However, while the prevalence of some autoantibodies increases with age, the incidence of connective tissue diseases decreases with age. This study aims to determine the clinical and paraclinical characteristics of connective tissue diseases in the elderly population. Materials and Methods: We conducted a retrospective and descriptive study, from March 2010 to March 2021, in the Internal Medicine Department of Aristide Le Dantec Hospital, including all the medical records of patients followed up for connective tissue disease and whose symptomatology began at an age greater than or equal to 65 years. Epidemiological, clinical, paraclinical, therapeutic and evolutionary data were collected from a pre-established survey form and then processed using SPSS software. Results: Overall, 22 cases were collected out of 275 seen on consultation. They involved 16 women and 6 men, aged between 65 and 85 years with a median of 70 years. The mean duration of the clinical picture was 15.7 months with extremes of 1 and 96 months. The clinical symptoms were joint pain in 21 patients associated with dry eye and mouth syndrome in seven cases and one patient underwent isolated dry eye and mouth syndrome. Joint involvement was deforming in 13 patients. Poor general condition was noted in 20 patients. Biology showed anemia in 14 patients, hyperleukocytosis (2 patients) and thrombocytosis (5 patients). The sedimentation rate (SR) was accelerated in 9 patients and the C-reactive protein (CRP) was positive in 12 patients. Immunology showed a positive Latex test (3 patients/6), Waaler-Rose reaction (8 patients/13), anti-cyclic citrullinated peptides (anti-CCP) antibodies (11 patients/11), anti-nuclear antibodies (2 patients/4). Anti-extractable nuclear antigens (anti-ENA) antibody testing in 4 patients showed positive anti-U1RNP (1 case), anti-SSA and anti-SSB (1 case). Plain X-Rays of the hands, wrists and feet

关键词： Connective Tissue Disease Elderly Rheumatoïd Polyarthritis Sjögren’s Syndrome Dakar

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