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Diabetes Ketoacidosis in Pregnancy: A Retrospective Study from the Teaching Hospital of Pikine

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Open Journal of Endocrine and Metabolic Diseases 2023年第6期13卷 75-83页

作者： Nafy Ndiaye Ngone Diaba Diack Abdou Tall khadidiatou Samb Yakham Mohamed Leye Abdoulaye Leye Abdou Aziz diouf Alassane diouf Internal Medicine/Endocrinology-Diabetology Department Teaching Hospital of Pikine Cheikh Anta Diop University Dakar Senegal Department of Gynaecology-Obstetric Teaching Hospital of Pikine Cheikh Anta Diop University Dakar Senegal

Introduction: Diabetic ketoacidosis (Dka) in pregnancy is rare but associated with maternal and foetal morbidity and mortality. The objectives of this study were to evaluate the epidemiological, diagnostic, and prognostic characteristics of Dka in pregnant women in Dakar hospitals and to study the predictive factors of its occurrence. Methods: This retrospective study was conducted from January 2013 to January 2021 in the Internal Medicine/ Endocrinology-Diabetology-Nutrition and Gynaecology-Obstetrics departments of the National University Hospital Centre in Pikine, Senegal. Medical files of all pregnant women hospitalised for Dka during this period were collected. Results: A total of 10 patients were included in the study. Average age was 30.9 years. Two patients with unplanned pregnancies had pre-gestational diabetes mellitus (pre-GDM) and did not have regular diabetic follow-up. Among the 8 patients with GDM, risk factors for GDM were found in 7 women, and three had a history of GDM. Blood glucose levels were >1.02 and >11 g/L for these two groups, respectively. None of the women had been systematically screened for GDM between 24 and 28 gestational weeks. Signs of ketosis were present: 6 patients had Kussmaul dyspnea and one patient had a Glasgow Coma Score of 10/15. The precipitating factor was infection in three patients. Two patients had pre-eclampsia. The evolution of Dka was favourable in all patients. For pregnancy outcomes: 4 cases of intrauterine foetal death were recorded, 2 women carried their pregnancy to term, a woman gives birth prematurely and 3 patients were lost to follow-up. Conclusion: Dka during pregnancy is rare in Dakar hospitals but health risk increases with the lack of screening for GDM in pregnant women, follow-up in a specialised environment, and pregnancy planning in diabetic patients. The obstetrical prognosis is poor for GDM patients, with a high rate of foetal death in utero.

关键词： Diabetic Ketoacidosis Gestational Diabetes Mellitus Pregnancy Pikine Senegal

Lesions Superimposed by Traditional Medicine on Renal Biopsies in Senegal

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Open Journal of Pathology 2023年第4期13卷 224-228页

作者： Cherif Mouhamed Moustapha Dial Toni Djibrilla Gani El Hadji Fary ka Abdou Niang Boucar diouf Pathology Laboratory of the Idrissa Pouye General Hospital Dakar Senegal Reference General Hospital Niamey Niger Nephrology Department of Aristide le Dantec Hospital Dakar Senegal

Traditional African medicine products are responsible for kidney damage that baffles both nephrologists and pathologists. Renal biopsies reveal acute or chronic inflammatory changes that cannot be explained by the progressive stage of the basic lesion of the nephropathy. The aim of this study is to analyze the lesions superimposed on 73 kidney biopsies from patients who took traditional herbal medications to treat the symptoms of kidney disease.

关键词： Nephropathy Traditional Medicine Pharmacopoeia Senegal

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

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

MINOCA Resulting from Coronary Spasm Confirmed Angiographically without Ergonovine Stimulation: A Case Report

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World Journal of Cardiovascular Diseases 2022年第11期12卷 473-480页

作者： Serigne Cheikh Tidiane Ndao Mame Madjiguène ka Waly Niang Mboup khadidiatou Dia Djibril Marie Ba Demba Waré Balde Mouhamed Chérif Mboup Cardiology Department H&ocirc pital Principal Dakar Dakar Senegal Cardiology Department H&ocirc pital Militaire de Ouakam Dakar Senegal

Introduction: Myocardial infarction with nonobstructive coronary arteries disease (MINOCA) encompasses a heterogeneous group of disorders. Multimodality imaging is crucial to figure out the underlying mechanism. Coronary artery spasm is a common cause of MINOCA and might be difficult to identify. Case Presentation: A 43-year-old male with no cardiovascular risk factor presented with prolonged acute chest pain at 5 am that resolved spontaneously. On admission, he was asymptomatic and clinical findings were unremarkable. The electrocardiogram showed an anterolateral negative T wave. The troponin was positive. Coronary angiography (CA) revealed a moderate lesion of the proximal left anterior descending (LAD) coronary artery. He was treated with dual antiplatelet therapy, statin, and beta-blocker with a favourable hospital course. One week later, he presented chest pain recurrences with anterior ST-segment elevation. CA, without intra-radial nitrate, owing to a vasospasm suspicion, showed a sub-occlusion of the proximal LAD which resolved after intracoronary nitrates. Chest pain and ST-segment elevation then disappeared. He remained asymptomatic and was discharged on CCB (calcium channel blocker), long-acting nitrates dual antiplatelet and statin. Cardiac magnetic resonance (CMR) demonstrated an ejection fraction (EF) of 45% with anterior ischemia. Conclusion: Our case is about a common cause of MINOCA, namely coronary spasm, diagnosed by coronary angiogram without provocative test.

关键词： MINOCA Coronary Spasm Case Report

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

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

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

Profile of Plasma Galectin-3 Concentrations, Inflammatory Cytokines Levels and Lymphocytes Status in Breast Cancer under Chemotherapy

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Open Journal of Immunology 2022年第1期12卷 1-14页

作者： Doudou Georges Massar Niang Sidy ka Jacobus Hendricks Doudou diouf Folly Mawulolo Gaba Adame diouf Maimouna Diop Moustapha Mbow Babacar Faye Rokhaya Ndiaye Diallo Maguette Deme Sylla Niang Ahmadou Deme Babacar Mbengue Alioune Dieye Unit of Immunology FMPOS Cheikh Anta Diop University Dakar Senegal Unit of Immunology Aristide Le Dantec Hospital Dakar Senegal Joliot Curie Institute Aristide Le Dantec Hospital Dakar Senegal Department of Physiology University of Limpopo Limpopo South Africa Unit of Human Genetics FMPOS Cheikh Anta Diop University Dakar Senegal

We investigated relationship between galectin-3 (Gal-3) levels and T lymphocytes apoptosis and the activation rates in breast cancer during chemotherapy. We used plasma samples from 112 women classified into two groups: 70 women with breast cancer (BC) and submitted to neoadjuvant chemotherapy (3 cycles) and 42 healthy women used as controls. In the group of BC, blood samples were taken before each cycle of chemotherapy and Gal-3 levels was evaluated by ELISA sandwich. Flow cytometry was used to study T cells apoptosis and activation. Before treatment, median value of Gal-3 was 6.31 ng/ml (range 1.07 - 50.74) in BC and 0.84 ng/ml (range 0.00 - 4.82) in HC. Gal-3 levels were highest in plasmas from BC (p p p = 0.010). In addition, we found a dynamic relationship between gal-3 levels, tumor size and T lymphocytes apoptosis rates during treatment depending to the cure efficiency. We suggest gal-3 plasma concentrations could be used as predictive biomarker for chemotherapy efficiency in breast cancer patients.

关键词： Galectin-3 T Lymphocyte B Lymphocyte Breast Neoplasms