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Acute Thoracic Syndrome in Children: Epidemiological, Diagnostic and Evolutionary Aspects at the Albert Royer National Children’s Hospital in Dakar Senegal

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Open Journal of Pediatrics 2023年第6期13卷 763-773页

作者： Guillaye Diagne Papa Souleye sow Khadim Bop maimouna sow Idrissa Demba Ba Albert Royer National Children’s Hospital Dakar Senegal

Acute chest syndrome (ACS) is a serious pulmonary complication of sickle cell disease. It is estimated to be responsible for a quarter of deaths in the pediatric sickle cell population. In Senegal, there are not enough pediatric studies in this area. The objective of our study was to determine the epidemiological, diagnostic and evolutionary characteristics of ATS at the Albert Royer National Children’s Hospital (CHNEAR) in Dakar. This was a retrospective study in patients hospitalized at CHNEAR for ATS from January 1, 2021 to March 31, 2022. We included patients hospitalized and diagnosed with ATS. We had collected 102 patients, i.e. a hospital incidence of 2.96%. The average age of the children was 9 years old;the sex ratio was 1.04. The main symptoms on admission were hypoxemia (97.06%), chest pain (77.45%), dyspnea (77.45%) and fever (65.69%). 52.94% of patients had an associated vaso-occlusive crisis (VOC). The chest x-ray was abnormal in 92 patients, a rate of 90.20% and showed images of pneumonia (71%);bronchitis (17.65%) and pleurisy (0.98%). None of the children benefited from a pulmonary ultrasound. The treatment associated with analgesics (100%), broad-spectrum antibiotics (100%), oxygen therapy (100%), hydration (95.09%), transfusion (73.53%), non-ventilation invasive (6.86%), intubation (2.94%) and beta 2 mimetics (12.75%). No patient benefited from incentive spirometry. Almost all of the patients 95.10% (n = 97) had a favorable clinical evolution. However, five children (4.90%) had an unfavorable outcome including one case of complication such as stroke (0.98%) and four (4) cases of death. The average hospital stay was 8 days. ATS is common in children with sickle cell disease in Senegal and its etiologies seem to be dominated by infectious causes in our context.

关键词： Acute Chest Syndrome Sickle Cell Disease Children Senegal

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The COVID-19 Pandemic in Senegal: Experience of an Internal Medicine Department as an Epidemic Treatment Center

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Open Journal of Internal Medicine 2022年第1期12卷 13-21页

作者： Atoumane Faye Awa Cheikh Ndao Nafissatou Diagne Mouhamed Dieng maimouna sow Baidy Sy Kane Boundia Djiba Abdoulaye Pouye Internal Medicine Department University Hospital Center Le Dantec Dakar Senegal

Introduction: The COVID-19 pandemic has turned the global health system upside down. Senegal recorded its first case on 2 March 2020. As part of its control strategy, the internal medicine department was set up as an epidemic treatment center (ETC). We report on our experience in the management of patients hospitalized in the said center. Material and Methods: Retrospective and descriptive study with analytical aim carried out at the ETC of the CHU Le Dantec of Dakar during the period from 29 April to 30 October 2020 (1st wave) then from 30 December 2020 to 30 April 2021 (2nd wave). All hospitalized patients who tested positive for RT-PCR were included. Epidemiological, clinical, paraclinical and evolutionary data were collected from a pre-established survey form and analysed using the software. Results: Five hundred and seventy files were collected: 379 patients (66%) in the 1st wave and 191 patients (34%) in the 2nd wave. There were 312 men and 258 women, i.e. a sex ratio of 1.22. The median age was 56 years [1.5 - 100 years]. Two thirds of the patients (66%) were over 50 years of age and 223 patients (39.1%) were over 65 years of age. Community transmission was reported in 72% of cases. The average length of hospital stay was 10 days [1 - 32]. Clinically, the mild form predominated (50.9%);the severe and critical forms were 32.6%. Comorbidity was noted in 68% of patients. The different comorbidities were: hypertension (36.1%), diabetes (28.2%), advanced CKD (9.8%). The case fatality rate was 17.2% with a mean age of 70 years. Conclusion: COVID-19 is responsible for respiratory but also systemic manifestations. This 3rd pandemic particularly affects vulnerable people with a significant morbidity and mortality, thus requiring the implementation of standardized CTE with multidisciplinary teams in the control strategies.

关键词： Pandemic COVID-19 Comorbidities Lethality

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Decentralised Management of Type 2 Diabetes in a Decentralised Centre for the Management of Type 2 Diabetes

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Open Journal of Internal Medicine 2023年第4期13卷 395-407页

作者： Boundia Djiba Nafissatou Diagne Demba Diédhiou Coumba Mbayar Diouf Djibi sow Mohamed Dieng Michel Assane Ndour Awa Cheikh Ndao Atoumane Faye maimouna sow Baidy Sy Kane Abdoulaye Pouye Faculty of Medicine Cheikh Anta Diop University Dakar Senegal

Introduction: Diabetes mellitus is a heterogeneous metabolic disorder characterized by the presence of chronic hyperglycemia due to a lack of secretion and/or action of insulin on the target tissues. Type 2 diabetes accounts for 90% of all diabetics. Despite the few specialists, there is a policy of decentralization of these patients. Patients and Methods: This was a retrospective cross-sectional study of the records of diabetic subjects followed in ambulatory at the internal medicine department of the EPS of Mbour. The recruitment of our patients took place over a period of sixty-three (63) days (from 03 May 2021 to 05 July 2021). Results: During the study period we collected 163 patients and most of those were female with a sex ratio of 0.68. The most represented age group was 46 - 55 years;82.8% of patients came from Mbour. Diabetes was initially discovered in 65 patients (39.9%) and known in 98 patients. 72 patients in our population had previous follow-ups in a health facility;Almost all of the 146 patients had at least one FDR of T2D, i.e. 89.6%. Cardiovascular risk factors were present in 96 patients. The majority of patients (138) came for simple follow-up, 11 for acute complications and 16 for chronic complications. 36 patients in our population had at least one microangiopathic complication of diabetes, 18 a macroangiopathic complication and 18 an infectious complication. In our study, 102 patients had a very high cardiovascular risk, 42 patients had a high risk, and 19 patients had a moderate risk. Conclusion: Diabetes is a real public health emergency because of its magnitude and complications. A strengthening of the policies of decentralization of the management will allow better management of patients who are not from Dakar.

关键词： Type 2 Diabetes Complications Decentralization Mbour

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Haemorrhage Secondary to Cerebral Aneurysm in a Senegalese Patient with Systemic Lupus Erythematosus:A Case Report

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Health 2019年第12期11卷 1625-1630页

作者： Baidy Sy Kane maimouna sow Boundia Djiba Awa Cheikh Ndao Mohamed Dieng Souhaibou Ndongo Abdoulaye Pouye Department of Internal Medicine Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal

Introduction: Hemorrhage by ruptured cerebral aneurysm is a rare and severe complication of systemic lupus erythematosus (SLE). We reported a case of this complication. Observation: A 24-year-old woman black Senegalese patient was followed in our department since for a systemic lupus with cutaneous and articular involvement and class III and V Lupus nephritis. She was readmitted for acute headache and early postprandial vomiting. The examination showed a meningeal syndrome, a subacute lupus eruption in the trunk, panniculitis and fever. The cerebral computer tomography showed spontaneous haemorrhage from saccular aneurysm. She was managed by immediate aneurysm clipping and medical treatment including bolus of methylprednisolone and immunosuppressive therapy was maintained. The outcome was favourable, but there was neurological damage such as brachial weakness. Conclusion: Hemorrhage by ruptured cerebral aneurysm is a rare and severe complication of SLE. The risk of damage is also significant. Immediate neurosurgical management and aggressive medical treatment may improve the prognosis.

关键词： Systemic Lupus Erythematosus Central Nervous System Lupus Subarachnoid Hemorrhage Africa South of the Sahara

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Myasthenia Associated with Other Autoimmune Diseases: A Series of Cases

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Open Journal of Internal Medicine 2020年第1期10卷 44-50页

作者： Boundia Djiba Nafissatou Diagne Mohamed Dieng Baidy Sy Kane Atoumane Faye Awa Cheikh Ndao maimouna sow Abdoulaye Pouye Department of Internal Medicine Aristide Ledantec Hospital Dakar Senegal

We report four observations of myasthenia gravis associated with other autoimmune diseases. Myasthenia gravis can be associated with all autoimmune diseases with a predominance of dysthyroidism. Among the autoimmune diseases associated with myasthenia gravis in our series, there were associations with hyperthyroidism, sjogren syndrome, Biermer’s disease. You would have to know how to look for another autoimmune disease in front of all myasthenia gravis by looking for the slightest sign of appeal that could point you towards another pathology.

关键词： Myathenia Gravis Autoimmun Disease Association

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Association of Hashimoto’s Thyroiditis and Graves’ Disease: A Case Report and Review of the Literature

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Case Reports in Clinical Medicine 2021年第10期10卷 303-307页

作者： Nafissatou Diagne maimouna sow Atoumane Faye Awa Cheikh Ndao Mouhamed Dieng Boundia Djiba Baidy Sy Kane Abdoulaye Pouye CHU Aristide Le Dantec de Dakar Dakar Senegal

Graves’ disease and Hashimoto’s thyroiditis are two common autoimmune diseases. Their association with other autoimmune diseases is not exceptional. However, the co-occurrence of these two diseases is not often described. In this case, report, we describe the observation of a patient who had long been followed for exophthalmos and pretibial myxedema as a sign of thyrotoxicosis. Examination of this patient revealed a clinical picture of clinical and biological hypothyroidism related to Hashimoto’s thyroiditis. This case had made it possible to retain an association between Hashimoto’s thyroiditis and basedowdisease, which is rarely described. This observation underscores the importance of monitoring these patients with autoimmune disease systematically even if there is no clinical manifestation.

关键词： Hashimoto Graves’ Disease Antibodies Dakar

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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 noted in 1 patient (0.8%). In Hashimoto’s thyroi

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

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Seronegative Myasthenia Gravis and a Biermer’s Anemia:A Rare Association

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Open Journal of Internal Medicine 2017年第4期7卷 160-164页

作者： Boundia Djiba Baidy Sy Kane Awa Cheikh Ndao Michel Assane Ndour Nafissatou Diagne Atoumane Faye Mohamed Dieng maimouna sow Abdoulaye Pouye Department of Internal Medicine Center Hospital Aristide Le DantecDakarSenegal

We report a rare association of seronegative myasthenia gravis and a Biermer’s anemia (or pernicious anemia). A Senegalese patient of 31 years has been followed for a vitamin B12 deficiency anemia, 12 months before his hospitalization in our department. She has been admitted for an intense and invalidating fatigability in spite of the correction of anemia, associated to a right ptosis. This clinical picture has electively been improved to the prostigmine test. The electromyography had revealed a compatible decrement with a diagnosis of myasthenia. The positivity of the antibodies anti gastric parietal cells and the twice negativity of the antibody against acetylcholine receptor (AChR) and muscle-specific kinase (MuSK) had permitted to deduct a diagnosis of seronegative myasthenia and Biermer’s anemia. The evolution was favorable under substitutive B12 vitamin therapy associated to corticotherapy and azathioprine. We insist on the research and the early treatment of a myasthenia, in a context of Biermer’s anemia, before suggestive clinical signs in spite of the negativity of the anti-Rach antibodies and anti-Musk.

关键词： Myasthenia Gravis Pernicious Anemia Seronegative

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Ankle-Brachial Index in Systemic Lupus Erythematosus:A Senegalese Case-Control Study

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World Journal of Cardiovascular Diseases 2019年第12期9卷 958-968页

作者： Baidy Sy Kane maimouna sow Fatou Aw Abdourahmane Samba Ahmed Tall Lemrabott Awa Cheikh Ndao Souhaibou Ndongo Mouhamadou Bamba Ndiaye Maboury Diao Abdoulaye Pouye Department of Internal Medicine Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal Department of Cardiology Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal Biochemistry Laboratory Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal Department of Nephrology Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal

Systemic lupus erythematosus (SLE) is associated with accelerated atherosclerosis and increasing cardiovascular risk which is recognized as a major cause of morbidity and death. Whether subclinical atherosclerosis has been evaluated by several methods, there are very limited data about Ankle-Brachial Index (ABI) in patients with systemic lupus erythematosus. The aim of the present study was to compare this index, between SLE patients and controls. We conducted a case-control study in the Department of Internal Medicine of our institution during the period from August 1, 2017 to December 31, 2018. We included 100 subjects, including 50 SLE patients and 50 control cases. This included 44 women and 6 men in patients with an identical distribution in controls. The mean age was 33.5 ± 11.3 years for cases and 33.3 ± 11.3 years (p-value: 0.93) for controls subjects. There was higher frequency of cardiovascular risk factors such as dyslipidemia (p-value at 0.009), low level of serum HDL-cholesterol (p-value??0.001), hypertriglyceridemia (p-value at 0.000) and hyperuricemia (p-value at 0.000) in patients with SLE. Overweight/obesity was higher in controls subjects (p-value at 0.028). There was no statistically significant difference in the frequency of diabetes-mellitus, smoking and high blood pressure. The abnormally ABI was recorded in 19 patients with SLE (38%) and 8 controls (16%) with a p-value: 0.01 and odds ratio: 3.22. Eight patients (16%) and four controls (8%) had low ABI without significant difference (p-value: 0.11 but odds-ratio at 2.98). Eleven patients with SLE (22%) and five controls (10%) had high ABI (p-value: 0.05 and odds-ratio: 3.24). In patients with SLE only disease activity (cSLEDAI) at the inclusion of the study was correlated?to abnormal ABI.?Conclusion:?This study showed an increasing prevalence of abnormal ABI in black African patients with SLE compared to controls with a correlation between disease activity and abnormal ABI.

关键词： Systemic Lupus Erythematosus Subclinical Atherosclerosis Peripheral Arterial Disease Ankle-Brachial Index Africa South of the Sahara

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Cardiovascular Risk and Subclinical Atherosclerosis in Senegalese Patients with Rheumatoid Arthritis:A Cross-Sectional Study in a Single Centre

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World Journal of Cardiovascular Diseases 2020年第1期10卷 1-11页

作者： Baidy Sy Kane Awa Cheikh Ndao Abdourahmane Samba Mame Madiguène Ka maimouna sow Fatou Aw Mohamed Dieng Souhaibou Ndongo Mouhamadou Bamba Ndiaye Maboury Diao Abdoulaye Pouye Department of Internal Medicine Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal Biochemistry Laboratory Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal Department of Cardiology Le Dantec Teaching HospitalCheikh Anta DIOP UniversityDakarSenegal

Introduction: Rheumatoid arthritis (RA) is associated with increasing of cardiovascular (CV) morbidity and mortality due to accelerated atherosclerosis. Several studies showed also the increasing of the prevalence of subclinical atherosclerosis, but there are little data from sub-Saharan Africa. The aim of our study was to assess the prevalence of cardiovascular risk factors, subclinical carotid atherosclerosis and the ability of the Systematic Coronary Risk Estimation (SCORE) modified by European League Against Rheumatism (EULAR) to predict the high CV risk in our patients. Patients and Method: We conducted a cross sectional study in Senegalese patients with RA. The RA was retained according to 2010 American College of Rheumatology (ACR)-European League Against Rheumatism (EULAR) criteria. Patients with RA were assessed in a clinical research consultation. Results: We included 50 RA patients. The mean age was 44 years (+/- 12.37) and the sex-ratiowas 0.06. The frequency distribution of traditional cardiovascular risk factors was: hypertension (HT) (30%), diabetes-mellitus (6%), smoking (2%), no-exercise (22%), obesity (16%), metabolic syndrome (8%). Fifty-eight percent of patients were classified at low cardiovascular risk according to mSCORE. 51.7% of patients classified as moderate-risk according to mSCORE, were reclassified as high cardiovascular risk according to carotid ultrasound evaluation (gold-standard). The sensitivity of the mSCORE in the prediction of high CV risk was low at 20%. In the present study, the prevalence of carotid subclinical atherosclerosis was 20%. Age (>45 years) and HT were correlated to subclinical atherosclerosis. Conclusion: In the present study, the prevalence of atherosclerosis in RA patients was higher than expected frequency in comparison with the prevalence in Senegalese general population. We showed that CV risk was underestimated by mSCORE which had a low sensitivity in the prediction of high risk. We showed also the importance of carotid ultrasound for an appropriate strat

关键词： Rheumatoid Arthritis Subclinical Atherosclerosis Africa South of the Sahara

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