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Assessment Postpartum Glucose Status among Women with Gestational Diabetes: Experience of a Sub-Saharan African Endocrinology Department

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Journal of Diabetes Mellitus 2020年第3期10卷 124-131页

作者： Ngoné Diaba Diack Aminata Mbaye Nafy Ndiaye Yakham Mohamed Leye Abdoul Aziz Diouf Mamadou Ba khadidja Samb Papemomar Guisse Abdoulaye Leye Alassane Diouf Endocrinology-Diabetology Department Teaching Hospital of Pikine Dakar Senegal Obstetrics and Gynécology Department Teaching Hospital of Pikine Dakar Senegal

Background: Women with gestational diabetes mellitus (GDM) have a significantly increased risk for developing type 2 diabetes after delivery. The purpose of this study was to determine the postpartum glycemic status among women with GDM in an Endocrinology-Diabetology department in Sub-Saharan Area. Methods: It was a prospective cohort study conducted between January 1, 2013, and July 31, 2018 (over period of 5 years and 7 months) at Pikine National Hospital, Dakar, Senegal. Postpartum glucose status was evaluated at least 6 weeks post-partum among women with history of GDM according to IADPSG criteria. The glycemic status after delivery was pointed referring to 2006 WHO criteria. Results: Overall 53 patients were included in this study. Fasting plasma glucose was performed as a screening test in 94% of the cases. A type 2 diabetes after GDM as diagnosed in 6 patients, accounting for a prevalence of 11.32%. An Impaired Fasting Glucose (IFG) was revealed in 5 patients (9.43%). The patients underwent a screening test in the first year after delivery in 54.70% of the cases, over a half of whom during the post-partum period range from the 6th to the 12th week. Insulin usage during pregnancy was statistically correlated with the occurrence of postpartum diabetes. Conclusion: Diabetes prevention and early diagnosis require a glycemic status monitoring among women with history of GDM.

关键词： Gestational Diabetes Mellitus Postpartum Glucose Status Type 2 Diabetes Africa IADPSG

HIV and Seroconversion among Pregnant Women at the University Hospital of Mother and Child in Chad

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Journal of Biosciences and Medicines 2023年第1期11卷 106-115页

作者： Fissou Henry Yandai Ali Mahamat Moussa Mahamat Ali Bolti Djidda Abakar Oumar Hissene Adanaou khadidja Attimer Hamit Mahamat Alio Kuan Abdoulaye Traore Nicolas Barro Institut de Recherche en Elevage pour le Développement (IRED) N’Djamena Tchad Centre Hospitalier Universitaire la Renaissance (CHU-R) N’Djamena Tchad Laboratoire de Biologie Moléculaire d’Epidémiologie et de Surveillance des Bactéries et Virus Transmissibles par les Aliments (LaBESTA) Université Joseph KI-ZERBO Ouagadougou Burkina Faso Faculté des Sciences de la Santé Humaine (FSSH) N’Djamena Tchad Laboratoire de Sciences de la Vie et de la Terre (LaSVT) Université Norbert ZONGO Koudougou Burkina Faso

Background: HIV in pregnant women presented a risk of transmission to newborns. This study was to determine HIV prevalence among pregnant women in the birthing rooms and give antiretrovirals to women infected and their newborns. Methods: A preliminary study was conducted from 2013 to 2015 at the Mother and Child Hospital. Pregnant women were counseled and tested for HIV-antibody according to the national algorithm using Determine HIV 1 & 2 and Immunocomb II Bispot HIV1 & 2. The women screened HIV-negative during the prenatal consultation and who accepted a second test were screened in the birth room. The data collected were processed using the Access Microsoft office 16 and SPSS software version 18. Results: A total of 6080 pregnant women were tested before and in the birth room. Of these, 5943 (97.4%) were detected as HIV-negative and 159 (2.6%) were HIV-positive. Of the 5943 with HIV-negative status, 1333 accepted the second test in the birth room, 10 of which have become HIV-positive. The rate of seroconversions was 0.75%. Conclusion: This study determined the prevalence of HIV in pregnant women. The result reveals the importance and necessity of repeating the screening test in the birth room because of the possibility of seroconversion or new infection during pregnancy.

关键词： HIV Prevalence Seroconversion Pregnancy Chad

Management and Maternal-Fetal Prognosis of Placental Abruption: A Retrospective Study of 130 Cases

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Open Journal of Obstetrics and Gynecology 2022年第7期12卷 590-598页

作者： Papa Malick Ngom Faye Marie Edouard Gaye Yaye Fatou Sylla Mafing Aya Tine Marguerite Ndew Inzale Mohamed Amine Bentaleb Hajar Fall khadidja Koné Madjiguène Fall Mouhamadou Mansour Department of Obstetrics Gynecology Dakar Principal Hospital Dakar Sénégal Gynecological and Obstetrical Clinic Hopital Aristide Le Dantec Dakar Sénégal Department of Neonatology Dakar Principal Hospital Dakar Sénégal Department of Anesthesia Dakar Principal Hospital Dakar Sénégal Resuscitation Service Dakar Principal Hospital Dakar Sénégal

Objective: To describe the epidemiological, clinical and prognostic factors and assess treatment of placental abruption in the obstetrics gynecology department of the Dakar Principal Hospital. Patients and Method: We carried out a retrospective observational study of 130 successive cases of placental abruption, which occurred from January 2015 to December 2017 at the Level 3 Maternity Unit of the Dakar Principal Hospital. Data were collected from non-computerized obstetric records and analyzed using Excel and Epi info software. Results: There were 130 cases of placental abruption, that is a prevalence of 1.5%. The average age of onset of placental abruption was 30 years. The history of hypertension concerned 32.3% of patients, the average gestational age of 32.5 weeks at the time of diagnosis, grade 3 of Sher was found in 48.5% of cases. The outcome of the pregnancy was a caesarean section in 79.2% of cases, the average weight of newborns was 2058 g. The management of the complications required a blood transfusion and intensive care. A haemostasis hysterectomy was performed in 6.2% of cases. Stillbirth rate was 53.7% and maternal mortality was zero. Discussion and Conclusion: Placental abruption, a severe complication of pregnancy, is associated with high perinatal morbidity and mortality linked to the severity of the clinical picture, despite an improved maternal prognosis.

关键词： Placental Abruption Perinatal Mortality Maternal Morbidity

Resistance to Anti-Thyroid Drugs in Graves’ Disease: Clinical-Biological Characteristics and Alternative Therapy in Tropical Area

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Open Journal of Endocrine and Metabolic Diseases 2020年第11期10卷 147-153页

作者： Ngoné Diaba Diack Nafy Ndiaye Mbaye Sene Mamadou Ba Ndeye Fatou Thiam khadidja Samb Pape Momar Guisse Sokhna Awa Balla Sall Aida Diop Diene Marylin Zohoun Yakham Mohamed Leye Abdoulaye Leye Department of Endocrinology Pikine Teaching Hospital Cheikh Anta Diop University Dakar Senegal Department of Otorhinolaryngology Military Hospital of Ouakam Dakar Senegal

Background: Resistance to anti-thyroid drugs (ATDs) is a rare entity recently described. We report two African observations in the treatment of Graves’ disease. Case 1: A 19-year-old Senegalese woman presented on admission with thyrotoxicosis syndrome associated with diffuse goitre and Grave’s orbitopathy. TSH levels were low (0.005 mIU/ml;N = 0.27 - 4.20) and fT4 elevated (60 pmol/L;N = 12 - 22]. Combination therapy with propranolol (40 mg/day) and carbimazole (starting dose of 45 mg/day and increased to 60 mg/day) was initiated. In view of the persistence of symptoms despite good therapeutic compliance, carbimazole was replaced by methimazole with an initial starting dose of 40 mg/day, followed by 60 mg/day. Despite the change in therapy, clinical symptoms of thyrotoxicosis persisted, and fT4 levels remained elevated. The patient was diagnosed with resistance to ATDs in Graves’ disease. Total thyroidectomy following 10 days of preoperative preparation with 1% Lugol’s solution was performed successfully. Case 2: A 22-year-old woman was referred for continued management of Graves’ disease with elevated thyroid-stimulating hormone receptor antibody (TRAb) levels (34 UI/mL;N arbimazole at an unusual dose of 80 mg/day. Combined therapy was clinically and biologically ineffective, with an fT4 level of 100 pmol/L [N: 12 - 22]. Upon admission, methimazole (40 mg/day) followed by propylthiouracil (800 mg/day) replaced carbimazole. Despite good patient compliance, the patient’s symptoms remained unaltered and fT4 levels elevated. A total robot thyroidectomy using the right axillary approach was performed successfully after 10 days of preoperative preparation, including prednisone (40 mg/day) combined with 1% Lugol’s solution. Conclusion: Resistance to ATDs complicates the management

关键词： Resistance Antithyroid Drugs Graves’ Disease Lugol’s Solution Africa Senegal