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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

Rhabdomyosarcoma in Dakar: An Update on Pronostics Factors

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Open Journal of Pathology 2022年第1期12卷 37-45页

作者： Abdou Magib Gaye Marie Joseph Dieme-Haouidi Ibou Thiam Fabrice Senghor Gabriel Nougnignon Comlan Deguenonvo cherif mouhamed Moustapha dial Anatomy and Pathological Cytology Laboratory of the Aristide Le Dantec Hospital Dakar Senegal Anatomy and Pathological Cytology Laboratory of the Fann Hospital Dakar Senegal Anatomy and Pathological Cytology Laboratory of the Idrissa Pouye General Hospital Dakar Senegal

Rhabdomyosarcoma (RMS) belongs to the soft tissue sarcomas that have striated muscle differentiation. It is most common in young children under 5 years of age and adolescents. The definite diagnosis of rhabdomyosarcoma is based on histology and the positivity of striated muscle markers in immunohistochemistry. Our objective was to describe the prognostic characteristics of RMS diagnosed in Dakar. MATERIAL AND METHODS: This was a retrospective and descriptive study spread over nine (09) years from 1 January 2011 to 31 December 2019. It was conducted from the histological report archives of the anatomy and pathology laboratories of Dakar. Paraffin blocks were reread and immunohistochemically studied by manual method. Antidesmin and antimyogenin antibodies were used. RESULTS: We collected 44 patients with rhabdomyosarcoma out of 228 cases of soft tissue cancers, i.e. 19.29% of all malignant soft tissue tumours. The mean age of the patients was 25.41 ± 23.95 (standard deviation) years with a median age of 16 years and extremes of 6 months and 81 years. Patients were less than or equal to 17 years of age in 61.4% of cases. A clear male predominance was observed with 29 men (65.9%) against 15 women (34.1%). Rhabdomyosarcomas were located in the limbs in 34.1% of cases, in the head and neck in 29.5% of cases and in the genitourinary tract in 25% of cases. The average tumour size was 7.45 cm ± 4.64 (standard deviation) with a minimum of 2 cm and a maximum of 17 cm. It was greater than or equal to 5 cm in 15 patients (68.2%). Embryonal rhabdomyosarcoma (ERMS) was the most frequent histological type with 34 cases (77.3%), followed by pleomorphic rhabdomyosarcoma 7 cases (15.9%) and alveolar rhabdomyosarcoma 3 cases (6.8%). The histological subtypes of ERMS consisted of conventional ERMS (91.18%);botryoid RMS (5.88%) and spindle cell RMS (2.94%). The correlation between histological type and age was statistically significant (p = 0.039). A relationship was also observ

关键词： Rhabdomyosarcoma Prognosis Histology Dakar

Assessment of Total Incapacity for Work or Incapacity in the Criminal Sense in Case of Penetrating Wounds of the Neck

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Forensic Medicine and Anatomy Research 2018年第1期6卷 1-9页

作者： El Hadji Oumar Ndoye Bobo diallo Sidy Ahmed dia mouhamed Manibiliot Soumah Mame Coumba Fall Mor Ndiaye Department of Forensic and Labor Medicine University Cheikh Anta Diop (UCAD) Dakar Senegal ENT Department of the University Hospital Center of Fann Dakar Senegal

Penetrating wounds of the neck are often life-threatening. The victims are exposed to vascular and laryngotracheal lesions. The purpose of this work is to report the various aspects of the management of penetrating wounds in our context and to make the medico-legal assessment of incapacity in the criminal sense or total incapacity for work. This is a retrospective study (2002-2014) on thirty-nine (39) cases of penetrating neck wounds, received at the ENT departments of the Aristide Le Dantec and Fann University Hospital Centers. Patients were predominantly male, representing 94% of cases with an average age of 27 years. Seventy (70%) of the accidents occurred in the region of Dakar. In 42% of cases, the circumstance of occurrence was a fight or an assault. The weapon used in most cases by the aggressor was a cutter or a knife. The average waiting time was 37 hours with extremes of 02 and 216 hours. Surgically, all patients had been examined under general anesthesia. In terms of lesions, 37 cases had profound cervical muscle injuries, i.e. 94%. There were 17 vascular lesions (43%). The medico-legal distribution of patients showed that among them, 10% had a total incapacity to work exceeding 21 days. The determination of total incapacity for work is an important medical procedure that requires capability and experience. The doctor must not fall into the trap of the confusion between the TIW on the criminal level and the TIW on the civil level. He must limit medically and should not make judgments.

关键词： Penetrating Neck Wounds Assessment of Total Incapacity for Work Criminal Incapacity Forensic Medicine

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

Conservative Approach Might Be the Strategy by Default in Stable Angina Patients: A Case Report

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World Journal of Cardiovascular Diseases 2020年第11期10卷 769-774页

作者： Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Djibril Marie Ba Khadidiatou dia mouhamed Chérif Mboup Pape diadie Fall Department of Cardiology Hospital Principal Dakar Dakar Senegal

Management of stable angina is still a matter of debate. Whether a conservative or invasive approach is better remains unclear. Even though recent large-scale randomized trials depict the conservative strategy as safe and efficient. In this report, we present a case of a 53-year-old male patient with cardiovascular risk factors of hypertension and hypercholesterolemia. He complained about typical chest pain at exertion. The coronary angiogram (CA) revealed severe stenosis of the proximal left anterior descending artery (LAD) ostium. After heart team discussion, coronary artery bypass graft (CABG) was advocated. However, due to a lack of means, the CABG was postponed. Meanwhile, he was managed with guideline-based medical therapy. In addition, he exercised regularly and adopted a healthy diet. Evolution was favorable with excellent symptoms control. A regular follow-up was organized with his cardiologist. A new CA before an eventual CABG six years later showed a significant plaque volume regression of the proximal LAD. We decided to continue conservative management. The stress echocardiogram to assess symptoms and exercise tolerance was normal. Our patient was sent to surgery on top of optimal medical therapy even though angioplasty was a good indication and was feasible. However, while he was struggling to afford the CABG procedure, he adopted a very healthy lifestyle along with medical therapy. Six years later, the result of that approach was without appeal, suggesting and reinforcing the conservative management

关键词： Stable Angina Chronic Coronary Syndrome Conservative Treatment Case Report

Laryngeal Cancers at the Pathological Anatomical Laboratory (ACP) in Dakar about 215 Cases

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Open Journal of Pathology 2023年第2期13卷 79-86页

作者： Marie Joseph Dieme Ahouidi Adama Diedhiou Abdou Magib Gaye Dibor Niang Falilatou Seidou Ibou Thiam cherif mouhamed Moustapha dial Anatomy and Pathological Cytology Laboratory Fann Hospital Dakar Sénégal Anatomy and Pathological Cytology Laboratory Aristide Le Dantec Hospital Dakar Sénégal Anatomy and Pathological Cytology Laboratory Gaston Berger University St Louis Sénégal Anatomy and Pathological Cytology Laboratory Idrissa Pouye Hospital Dakar Sénégal

Introduction: Laryngeal cancer is the first cancer of upper aerodigestive tract. Dysphonia, dyspnea and dysphagia are evocative signs. diagnosis is histological and squamous cell carcinoma is the most common type. The objective of our study was to discuss epidemiological and anatomo-pathological characteristics of laryngeal cancers diagnosed in different pathological anatomy and cytology (ACP) laboratories of Dakar hospitals. Material and method: This was a retrospective study spanning from January 2013 to December 2018 at the pathological anatomy laboratories of Fann, Aristide Le Dantec and Idrissa Pouye hospitals. All patients with laryngeal cancer confirmed at histology were included. Data collection was based on clinical records of the patients and archives of histological reports of the pathological laboratories. Data analysis was performed under the Excel software. Results: We collected 215 cases of laryngeal cancer. The average age was 58.01 years with extremes of 07 and 94 years. The male sex was predominant with 183 patients (85.12%) against 32 women (14.88%). The most noted risk factor was tobacco which affected 14 patients, or 60.87%. Three patients (13.04%) did not present any alcohol-smoking impregnation. Clinically, dysphonia was noted in 22 patients (26.51%). It was associated with dyspnea in 0.48% of cases and dysphagia in 3.61%. Laryngoscopy was performed in 62 patients or 28.83% of cases, nasofibroscopy in 6.45% of cases. Cord arythenoid fixity was noted in two patients (3.23%) and hypo-mobility in 1 patient (1.61%). The most frequent local extension was involvement of the piriform sinus with 11.29% of cases. Palpable lymphadenopathy reported in 17 patients (20.48%). Pathological examination was performed in all patients after post endoscopic biopsy in 92 patients (42.79%), and after obtaining the operative specimen in 123 cases (57.21%). The three floors affected 76 patients (35.35%). The ulcerative budding aspect most noted concerned 108 patients

关键词： Laryngeal Cancer Carcinoma Dakar

Sex Differences in Clinical and Angiographic Characteristics in Acute Coronary Syndrome Patients in Dakar, Senegal

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World Journal of Cardiovascular Diseases 2022年第7期12卷 403-413页

作者： Serigne Cheikh Tidiane Ndao Mame Madjiguene Ka Waly Niang Mboup Aimé Gildas Portella Khadidiatou dia Pape diadie Fall mouhamed Chérif Mboup Department of Cardiology Hospital Principal Dakar Dakar Senegal

Background: Coronary artery disease (CAD) is in relentless progression, along with the adoption of western lifestyle in sub-Saharan Africa. In Senegal, the incidence of acute coronary syndrome (ACS) rose from 5% to 12% in Dakar during the last 20 years. That increase was observed in both women and men, and according to current data, the former paid the heaviest price in terms of mortality compared to men. In this study, we aim to retrospectively assess the clinical characteristics and angiographic profile of ACS in women compared to men in two tertiary care centers in Dakar. Methods: In this study, we retrospectively analyzed and compared data between men and women among 133 patients who underwent coronary angiogram for ACS in 2 tertiary centers from February 2019 to January 2020. Results: A total of 133 patients were included in our study of whom 97 (72.9%) were men. The mean age was 58 ± 13.6 years. Women were older than men (61.4 ± 14.3 years vs 56.6 ± 13.5 years (p = 0.07). Hypertension, sedentary lifestyle and obesity were significantly more frequent in women (69.4%, 52.7% and 19.4%) when compared to men (38.8%, 25.7% and 6.19%) respectively, (p = 0.001;0.002 and 0.03). Smoking was less frequent in women (2.8%) than in men (44.3%), (p Conclusion: In our study, women with ACS were older, had more cardiovascular risk factors but less angiographic extent of disease than men.

关键词： Sex Differences Acute Coronary Syndrome Senegal

Isolated esophageal tuberculosis:A case report

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World Journal of Gastrointestinal Endoscopy 2022年第9期14卷 575-580页

作者： Ibrahima diallo Omar Touré Elhadji Souleymane Sarr Abdoul Sow Bineta Ndiaye Papa Silman diawara cherif mouhamed dial Ababacar Mbengue Fatou Fall Hepato-Gastroenterology Hopital Principal de DakarDakar 3006Senegal Hepatogastroenterology Hopital Principal de DakarDakar 3006Senegal Department of Pathology Hopital Principal de DakarDakar 3006Senegal Department of Biology Hopital Principal de DakarDakar 3006Senegal Department of Pathology Hopital Général Idrissa PouyeDakar 3006Senegal Department of Imaging Hopital Principal de DakarDakar 3006Senegal

BACKGROUND Tuberculosis is endemic in *** its extra-pulmonary localization is rare,esophageal tuberculosis,particularly the isolated form,is *** report here a case of isolated esophageal tuberculosis in an immunocompetent *** SUMMARY A 58-year-old man underwent consultation for mechanical dysphagia that had developed over 3 mo with non-quantified weight loss,anorexia,and *** digestive endoscopy showed extensive ulcerated lesions,suggesting *** diagnosis was confirmed by histopathology,which showed gigantocellular epithelioid granuloma surrounding a caseous *** computed tomography scan did not show another localization of the *** outcome was favorable with *** Esophageal tuberculosis should be considered when dysphagia is associated with atypical ulcerated lesions of the esophageal mucosa,in an endemic area.

关键词： Tuberculosis Esophagus Endoscopy Case report

Epidemiological and Clinical Aspects of Autoimmune Dysthyroidism in Internal Medicine at Aristide Le Dantec Hospital

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Open Journal of Endocrine and Metabolic Diseases 2021年第11期11卷 171-179页

作者： Nafissatou diagne diatou Guèye dia Awa Cheikh Ndao Atoumane Faye Maimouna Sow mouhamed Dieng Boundia Djiba Baidy Sy Kane Abdoulaye Pouye Department of Medicine Senegal Université Cheikh Anta Diop Dakar Senegal Department of Medicine Senegal UFR Santé de Saint Louis Saint Louis Senegal

Introduction: Autoimmune thyroiditis is relatively common in medicine. However, comprehensive studies are few in number, especially in Africa and particularly in Senegal. The aim of this study was therefore to determine the epidemiological, clinical, profile of Autoimmune Thyroid Diseases (OITD). Materials and Methods: This was a retrospective descriptive study from 2016 to 2019 of the records of patients who consulted or were hospitalised for autoimmune dysthyroidism in the internal medicine department of the Aristide Le Dantec Hospital. During this period, 1227 new consultations were recorded;they concerned three specialized consultations including endocrinology. The autoimmune origin was confirmed in 159 patients, i.e. in 45.69% of cases the AIDM then 12.96% of all consultations. The autoimmune origin was established on clinical, biological and immunological grounds. The data were collected from the medical records of the patients and recorded on a pre-established individual survey sheet taking into account the objectives of the study. The data collected was entered into the Sphinx V5 software on an established form. The analysis was carried out with the following software: Excel 2010 and Epi info 7.2. Results: Among this dysthyroidism, 159 patients had a confirmed autoimmune thyroid disease. On all new consultations, OITD represented 12.96% of internal medicine consultations. The sex ratio M/F was 0.18. The majority of our patients (57.86%) were aged between 25 and 44 years with extremes ranging from 11 to 63 years. In Graves’ disease, the notion of an irritative spine was found in 60.27% of cases. Signs of thyrotoxicosis were present in 92.7% of cases. There was a goiter in 81.1% of cases with a vascular character in 76.47% of cases. Anti-THR antibodies were positive in 96.15% of cases. Complications were noted in 9 patients (6.5%) such as cardiothyreosis in 8 patients (5.7%) and malignant orbitopathy

关键词： Autoimmune Thyroid Disease Graves’ Disease—Hashimoto’s Thyroiditis Antibodies Dakar