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Contribution of Bone Scintigraphy in the Diagnosis of a Calcaneus Fatigue Fracture in a Case at the Nuclear medicine Department of Idrissa Pouye General Hospital (HOGIP) in Dakar

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Open Journal of medical Imaging 2020年第1期10卷 62-71页

作者： El-Hadji Amadou Lamine Bathily B. Ndong O. Diop m. S. Djigo K. Gueye A. Kokou G. Thiaw G. mbaye L. A. D. Diouf m. Soumboundou A. R. Djiboune P. m. Sy O. Ndoye m. Diarra m. mbodj Nuclear medicine Department General Hospital of Idrissa Pouye (HOGIP) Dakar Senegal Biophysical Laboratory FMPO Cheikh Anta Diop University (UCAD) Dakar Senegal Nuclear medicine Department Hospital Dalal Jamm Dakar Senegal Biophysical Laboratory University of Lome Lome Togo Laboratory of Physical and Pharmaceutical Biophysics FMPO Cheikh Anta Diop University Dakar Senegal

Introduction: Fatigue fractures are secondary to excessive, unusual, repeated mechanical stress, occurring on healthy bone. Bone scintigraphy (BS) with 99mTc-HmDP is an excellent means of diagnosis. We report a case of stress fracture of the calcaneus with scintigraphic diagnosis, in a marathon runner. Patient and methods: He is a 40-year-old athlete in overtraining with right calcaneal pain on running, intense at first, moderate in the middle and then persistent after exercise. The interrogation found no trauma to the right foot and the x-ray of the foot was without abnormality. The so 3 phases were performed following an injection of 564 mBq of 99mTc-HmDP, with a SPECT gamma camera. Results: Bone scintigraphy found in the early phase, hyper-perfusion and hyper-fixation of the right calcaneal region compared to its left counterpart and in the bone phase persistence of focal hyperfixation opposite the right calcaneus. This scintigraphic aspect of the right calcaneus in an overtrained marathon runner, in a painful context and in front of a normal X-ray, made us evoke a fracture of fatigue. A complementary CT scan performed two days after the BS was without abnormality. Conclusion: Fatigue fractures are micro-fractures generally not noticed on radiography and CT. BS due to its high sensitivity is an excellent or the best tool for the early diagnosis of stress fractures.

关键词： Fatigue Fracture Bone Scintigraphy Sports

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Effectivity of Thromboprophylxie in Dakar’s medical Areas

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Open Journal of Internal medicine 2020年第1期10卷 35-43页

作者： B. Djiba m. Dieng C. m. A. Halim m. Sow B. S. Kane m. A. Ndour B. C. Fall N. Diagne A. C. Ndao A. Faye S. Ndongo A. Pouye Department of Internal medicine Aristide Le Dantec Hospital Dakar-Étoile Senegal Department of Internal medicine Dalal Jam Hospital Dakar Senegal

Introduction: Venous thromboembolic disease (VTE) is a real public health problem worldwide. The practice guide produced periodically by the American College of Chest Physicians (ACCP) has become the international standard. However, thromboprophylaxis remains underused. methodology: We carried out a descriptive cross-sectional study. The goals of that study were to evaluate the effectiveness of the practice of thromboprophylaxis in the various medical services of the Dakar Public Hospitals. Our investigation was conducted for two weeks in September 2017. Results: 160 patients were included (81 men and 79 women) in our series, with male predominance: sex ratio of 1.02. The average age was 48. Infectious pathologies were the predominant clinical pictures (35% of cases). The thromboembolic risk factors (RF) mainly found were represented by prolonged bed rest, followed by cardiovascular (RF): age greater than 60 years (31.2%), hypertension (8.8%), obesity (4.4%) and diabetes (3.8%). The thromboembolic RF of patients hospitalized in these medical services has been evaluated empirically. We noted a lack of use of the VTE risk assessment scores. 40.9% (n = 56) of patients received overall VTE prophylaxis, a rate corresponding to almost half of those at risk (51.4%). This result reflects an under-use of thromboprophylaxis in the Dakar medical environment and a low level of adherence by practicians to the guidelines on VTE prophylaxis. Conclusion: It is therefore recommended to develop a national strategy to assess patients at risk for VTE, as well as measures to educate and inform doctors about the appropriate forms of thromboprophylaxis.

关键词： Thromboprophylaxis Anticoagulant Thromboembolic Disease

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Immunosuppressive Treatment of Connective Tissue Disease and Occurrence of Tuberculosis

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Open Journal of Rheumatology and Autoimmune Diseases 2020年第2期10卷 57-63页

作者： m. Dieng B. Djiba B. S. Kane B. C. Fall m. A. Ndour m. Sow N. Diagne A. C. Ndao A. Faye S. Ndongo A. Pouye Service de médecine Interne hôpital Aristide Le Dantec Dakar-étoile Sénégal Service de médecine interne hôpital Dalal Jam Dakar Sénégal

Introduction: The occurrence of tuberculosis (TB) during the follow-up of Connective tissue diseases (CTD) is a particular situation often posing real diagnostic problems. This is an association described in the literature. Patients and methods: We conducted a retrospective and descriptive study at the internal medicine department of Aristide Le Dantec Hospital. The purpose of this study was to determine the treatment that patients followed for CTD and suffering from TB took before the occurrence of this one. Results: During a study period of 11 years and 6 months, 21 cases of TB were diagnosed in 602 cases of CTD (0.03%). The predominance was female with a sex ratio (H/F) of 0.6. The median age was 42 years old. The majority of cases originated from the Dakar region (13 patients or 61.9%) and 85.7% had previous follow-up exclusively in modern medicine and 21 cases (95%) received the CTD’s treatment. This consisted of prednisone (90.5%) combined with methotrexate (52.4%), azathioprine (23.8%) or cyclophosphamide (19.4%). The respective medians doses of these drugs were 12.5 mg per day for prednisone, 13.5 mg per week for methotrexate and 100 mg per day for azathioprine. The median duration of patient follow-up was 36 months. The cumulative dose of prednisone during this period was 23.6 g and that of methotrexate 2.25 g. CTD were dominated by rheumatoid arthritis (RA) (57.1%), and systemic lupus (19%). Isolated cases of systemic scleroderma, primary Sjôgren, SHARP syndrom, mixed connective tissue disease, and multiple autoimmune syndrom were noted. TB was localized in 95% of cases, readily bilateral and poorly disseminated. The respective medians diagnostic delays for systemic disease and TB were 21 months and 5 months. Tuberculin intradermal reaction was performed in 16 cases and was positive in 9 cases, sputum bacilli was performed in 19 cases and was positive in 15 cases. Conclusion: The association of TB and CTD was characterized by its rarity, its poorly di

关键词： Tuberculosis Connective Tissue Disease Corticosteroid Immunosuppressive Therapy

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Impact of the Covid-19 Pandemic on the Prolongation of the management of myocardial Infarctions Seen Late: A Cross-Sectional Study of 25 Cases Collected in the Cardiology Department of the Aristide Le Dantec Hospital in Dakar (Senegal)

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World Journal of Cardiovascular Diseases 2021年第6期11卷 298-304页

作者： J. S. mingou S. Akanni H. B. Diop m. Bodian K. R. Diop S. A. Sarr F. Aw C. m. B. Diop P. G. Ndiaye Y. Diouf A. mbaye Ad Kane m. B. Ndiaye m. Diao A. Kane Cardiology Department CHU Aristide Le Dantec Dakar Senegal Cardiology Department H?pital Général Idrissa Pouye Dakar Senegal Cardiology Department Saint Louis Regional Hospital Saint Louis Senegal Cardiology Department Dalal Jamm Hospital Dakar Senegal

Background: Timely management determines the prognosis of patients admitted for acute coronary syndrome with persistent ST-segment elevation (STEmI). Coronavirus COVID-19 appeared in China, in Wuhan in December 2019, which has spread at a lightning speed across the planet earth, becoming a pandemic. Senegal, as well as countries around the world, has also been affected by this pandemic, which has had a strong impact on all its sectors of activity, particularly the health system. The objective of this study was to identify and evaluate the factors that increase the time required to treat myocardial infarctions, received late at H?pital Aristide le Dantec and to assess the impact of the Covid-19 pandemic on these delays. Results: A total of 25 patients were included: 17 patients in pre-pandemic period and 8 patients in pandemic period. The predominance was male with a sex ratio of 2.5. The mean age was 59.20 years. Hypertension was the leading risk factor with a prevalence of 60% followed by sedentary lifestyle (48%). Typical chest pain was the most frequent clinical symptom found on admission (80%) followed by nausea and vomiting (40%). The first medical contact took place in a hospital in most patients (44%) and was made by a general practitioner (64%). The majority of patients (76%) were referred to the cardiology department. The personal car was the most frequently used means of transportation for our patients (60%). The average distance by car between the place of occurrence and the hospital was 22.6 km with extremes of 3.30 and 36 km. The average travel time from the place of occurrence to the cardiology department was 43 min 30 mily:Verdana;">s with extremes of 11 and 57 min. When comparing the results according to the COVID-19

关键词： myocardial Infarction Delays Covid-19 Senegal

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Superficial myxoid Liposarcoma of the Thigh

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Open Journal of Orthopedics 2022年第2期12卷 50-56页

作者： mohamed Daffé Badara Diop Badara Dembélé Alioune Badara Diouf Lamine Sarr Charles Bertin Diémé André Daniel Sané Centre Hospitalier Universitaire Aristide Le Dantec Dakar Senegal Centre Hospitalier National dalal Jamm Guédiawaye Dakar Senegal

myxoid liposarcoma is the most common form of myxoid sarcoma. Their primary and superficial localizations are very rare compared to the deeper forms. We report the case of myxoid liposarcoma in a 57-year-old patient. The clinical picture marked by painless swelling of the right thigh had evolved over a period of about ten years. The diagnosis was guided by ultrasound and magnetic resonance imaging. A pathological examination of the surgical specimen after removal of the tumor helped to clarify the diagnosis. We discuss the clinical presentation and therapeutic management.

关键词： Liposarcoma myxoid Superficial Thigh Surgery

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The Behcet’s Disease: An Uncommon Cause of Venous Thrombosis in the Tropical Area: 10 Cases

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Open Journal of Internal medicine 2017年第4期7卷 177-184页

作者： B. C. Fall A. C. Ndao S. Sarr m. Dieng S. Ndongo A. Leye A. Pouye Department of Internal medicine Dalal Jamm Hospital Dakar Senegal Department of Internal medicine Le Dantec Hospital Dakar Senegal Department of Cardiology Le Dantec Hospital Dakar Senegal Department of Internal medicine Pikine Hospital Pikine Senegal

Introduction: The Behcet’s disease is deemed to be scarce in Black Africa where data are still scattered. The purpose of our study is to describe the epidemiological, clinical, paraclinic and evolutive particularities of the patients whose presenting symptoms of the Behcet’s diseases were a venous thrombosis. Patients and methods: It was a descriptive, multicenter, and cross-sectional study lasting 15 months. We brought together all the cases of the Behcet’s disease revealed by venous thrombosis. The diagnosis was based on clinical criteria of the international group of study of the Behcet’s disease in 2007. Results: We have grouped 10 revealing thrombosis cases of the Behcet’s diseases during our study period. The average age was 34. The average wait period between the appearances of the early symptoms and the diagnosis of the very disease was 30 months. The admission motives were the abdominal pain (2 cases), a thrombophlebitis of the lower limb (2 cases), headaches (1 case), coma (1 case), a thrombophlebitis of the upper limb (3 cases). The thrombotic symptoms were exclusively venous-located. The seats of the thrombosis were the vena cava superior in 30% of the cases, the vena cava inferior in 20% of the cases, the veins of the lower limb in 20% of the cases, the cerebral vein in 20% of the cases, and the auxiliary vein in 10% of the cases. The treatment of the deep venous thrombosis consisted in all the cases of an effective anticoagulation associated with the colchicine. Primarily, the corticotherapy with a high dose was used in all the patients. One of them in the comatose stage, manifesting both cerebral thrombophlebitis and aseptic meningitis, had died. Conclusion: Behcet’s disease is a disease of the young adult, but it must be evoked even in old age, with a view to appropriate management, in order to avoid the complications of the disease. Although it is rare in our regions, it should be sought in the etiological assessment of venous thrombosis whatever th

关键词： Behcet’s Disease Thrombosis Senegal

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Prevalence of Renal Failure in Children and the Need for Dialysis in Paediatric Nephrology in a Developing Country

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Open Journal of Nephrology 2022年第1期12卷 101-111页

作者： Younoussa Keita Aliou A. Ndongo Fatou Ly Ndeye C. Cisse Liliane N. D. m. Yamba Babacar Niang Djiby Seck Amadou Sow Ndeye F. Sow Abou Ba Indou D. Ly Aliou Thiongane Amadou L. Fall Idrissa D. Ba modou Gueye Pape m. Faye Assane Sylla Pediatric Unit of Aristide Le Dantec Hospital Dakar Senegal Pediatric Unit of Pikine Hospital Dakar Senegal Pediatric Unit of Albert Royer Hospital Dakar Senegal Pediatric Unit of Abass Ndao Hospital Dakar Senegal Pediatric Unit of dalal Diam Hospital Dakar Senegal

Background: Renal failure is among the major visceral failures responsible for morbidity and mortality in children. Epidemiological data on renal failure in children are limited in sub-Saharan Africa, including Senegal. We conducted this study to assess the prevalence of renal failure (RF) and the need for dialysis in the paediatric nephrology unit. Patients and methods: This was a retrospective and descriptive study in the pediatric nephrology unit from 1st January 2020 to 30 June 2021, including children with acute or chronic RF. The need for dialysis was judged to be met by its effectiveness in face of an indication. The data collected were analysed on sphinx plus 2017 software. Results: The prevalence of RF was 60% (n/N = 132/220). RF was acute in 59% (n/N = 78/132) of cases. The mean age was 6.53 ± 4.77 years with a sex ratio of 1.8. The mean serum creatinine level was 27.22 mg/L (240.9 μmol/L) and BUN at 0.85 g/L. The aetiologies were dominated by prerenal AKI (Acute Kidney Injury) complicating nephrotic syndrome (NS) in 37.2% (n/N = 29/78) and dehydration due to stomach flu in 17.6% (n/N = 9/51). Acute post-infectious glomerulonephritis including group A streptococcus and plasmodium falciparum accounted for 16.7% (n = 13/78) of intrinsic AKI. The need for dialysis was unmet in 50% (n/N = 7/14) with a mortality of 14.1% (n/N = 11/78). The mean age of the patients with chronic RF was 8.68 ± 4.74 years with a sex ratio of 2.6. The mean serum creatinine level was 36.56 mg/L (323.5 μmol/L) and the BUN level was 0.99 g/L. Half of the children were classified as having CKD stage II (early stage). The aetiologies were dominated by primary focal and segmental glomerulosclerosis (FSGS), 53.7% (n/N = 29/54), renal hypoplasia, 22.2% (n/N = 12/54) and reflux nephropathy, 29.4% (n/N = 5/17). The need for dialysis was unmet in 46.1% (n/N = 6/13). The overall mortality of chronic kidney disease (CKD) with RF was 29.6% (n/N = 8/27). Conclusion: The prevalence of RF was high i

关键词： Renal Failure Glomerulonephritis Hypodysplasia Dialysis Children

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Dosimetric Evaluation of the Scanning Activity at the Regional Hospital of Kaolack (Senegal)

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Open Journal of Biophysics 2021年第3期11卷 351-358页

作者： B. Ndong m. S. Djigo G. Akpo E. A. L. Bathily O. Diop A. R. Sanou A. K. Koutouan N. F. Badji F. Badji J. Wezzani K. Ka I. Thiam G. mbaye O. Ndoye m. mbodj E. H. Niang Biophysics Laboratory and Nuclear Medicine Cheikh Anta Diop University FMPO Dakar Senegal Radiology and medical Imaging Department of Aristide Le Dantec University Hospital Cheikh Anta Diop University Dakar Senegal Biophysics Laboratory and Nuclear medicine UFR Medical Sciences University Félix-Houphouet Boigny Cocody Abidjan C&ocirc te d’Ivoire Radiothérapy Department of the National Hospital University Center Dalal Jamm Guédiaway Dakar Sénégal Physics Pharmaceutical Laboratory Cheikh Anta Diop University FMPO Dakar Senegal

The aim of this study was to evaluate the dose delivered to patients during scannographic examinations at the Kaolack Regional Hospital (one of the 14 regions of Senegal located in the center-west of the country, 192 km from Dakar) and to compare these irradiation doses at diagnostic reference levels found in the literature in order to optimize our scanning protocols. To achieve this goal, we carried out a prospective study involving 218 CT scans. These examinations focused on cerebral, thoracic, abdominopelvic and lumbar spine acquisitions made in adults and cerebral only in children. We compared the median values of dosimetric indicators (CTDIvol and DLP) per acquisition with NRDs in the literature. During the course of this study, we found a dosimetric ratio lower than that of the NRDs for thoracic, abdomino-pelvic and lumbar spine CT scans in adults and a significant dosimetric exceedance for brain scans in adults and in children. These results encourage us to extend these dosimetric evaluations to other hospital structures in order to establish rigorous monitoring of dosimetric indicators and to respect the principles of radiation protection and good practice.

关键词： Dosimetry CT DRL Senegal

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Congenital Adrenal Hyperplasia: Diagnostic Features in a Limited Resource Country, Senegal

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Open Journal of Pediatrics 2020年第1期10卷 137-146页

作者： B. Niang F. Ly A. Ba A. mbaye D. Boiro P. m. Faye Y. J. Dieng A. Sow A. Thiongane I. D. Ba L. Thiam A. L. Fall O. Ndiaye Albert Royer National Children Hospital University of Dakar Dakar Senegal Pikine Hospital Centre University of Dakar Dakar Senegal dalal Diam Hospital Centre University of Dakar Dakar Senegal Abass Ndao Hospital Centre University of Dakar Dakar Senegal La Paix Hospital University of Ziguinchor Ziguinchor Senegal

Introduction:?Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive diseases characterized by enzymatic deficiencies in the biosynthesis of adrenal steroids. The most common 21-hydroxylase deficiency is characterized by a cortisol deficiency and an excess of androgens, with or without aldosterone deficiency. In our countries, in the absence of neonatal screening, the diagnosis is most often late leading to life-threatening complications. The aim of this study was to describe the diagnostic features of CAH at the Albert Royer National Children’s Hospital (ARNCH) in Dakar.?Patients and method:?We conducted a retrospective, descriptive study carried out at the pediatric endocrinology department of ARNCH from 2015 to 2019. All children aged under 15 with a form of CAH were included. Socio-demographic data, family history, clinical and biochemical data at presentation were collected. Patients were noted as presenting with Disorder of Sexual Development (DSD) with dehydration, DSD without dehydration, dehydration without DSD, precocious puberty. The Prader’s scale was used to determine the degree of external virilization. These data were entered and analyzed with Epi Info version 7.2.?Results:?A total of 32 patients were included, representing 74.41% of the causes of disorder of sexual development (DSD) and 84.21% of the causes of adrenal insufficiency. These were 27 girls (84.37%) and 5 boys (15.63%). The mean age was 19 ± 34.6 months. DSD was the main finding (87.5%). It was associated with dehydration in 22 cases (68.75%). 21-hydroxylase deficiency represented 93.75% of the cases with salt wasting in 73.33% of the cases.?Conclusion:?The diagnosis of CAH was delayed leading to life-threatening adrenal crises. In the absence of neonatal screening for CAH in Senegal, there is a need to train healthcare workers to recognize neonates with DSD early and refer them timeously for specialist care.

关键词： Congenital Adrenal Hyperplasia Disorder of Sexual Development Adrenal Insufficiency Senegal

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