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Epidemiological, Clinical, Paraclinical, Etiological and Therapeutic Aspects of Liver Cirrhosis in the Hepato-Gastroenterology Department of the Hospital Aristide Le Dantec in Dakar

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Open Journal of Gastroenterology 2022年第11期12卷 317-323页

作者： marie louise bassène Salamata Diallo marieme Polele Fall Mame Aissé Thioubou Téné Sidibé Coumba Cissé Mamadou Ngoné Gueye Department of Gastroenterology and Hepatology Hospital Aristide Le Dantec Dakar Senegal Department of Gastroenterology and Hepatology Peace Hospital Ziguinchor Senegal Department of Gastroenterology and Hepatology Hospital Idrissa Pouye Dakar Senegal

Introduction: Liver cirrhosis is a global public health issue. Our aim was to determine the epidemiological, clinical, paraclinical and therapeutic aspects of liver cirrhosis in the hepato-gastroenterology department of the hospital Aristide Le Dantec in Dakar. Patients and Methods: We conducted a retrospective study with a descriptive focus covering the period from January 1st, 2010 to December 31, 2020. We included the medical records of patients which presented body of clinical and paraclinical arguments which supported the diagnosis of cirrhosis. The data collected were related to age, gender, clinical, paraclinical, therapeutic and prognosis aspects of cirrhosis and were analyzed with the software Sphinx Plus. Results: Prevalence of cirrhosis was 6.2%. Sex ratio was 2.1%. The average age was 38 years. Asthenia (60.9%), altered performance status (60.1%), abdominal pain (37.2%), gastrointestinal bleeding (29.6%) and abdominal swelling (27.8%) were the most common motives of consultation. Physical examination revealed primarily portal hypertension (74.9%), liver failure (2.4%), hepatomegaly (28.2%) and anemia (13.7%). Viral hepatitis B was the most common etiology (81.9%). Abdominal screening (ultrasound/CT scan) showed hepatomegaly (80.6%), liver dysmorphia (87.7%), portal hypertension signs (85.3%) and portal vein thrombosis (18.2%). 55.1% Patients were classified as Child Pugh A, 33.8% were Child Pugh B and 11.1% were Child Pugh C. Tenofovir Disoproxil Fumarate (TDF) was prescribed to all patients affected by hepatitis B virus only. Evolution was characterized by clinical improvement and prognosis reclassification. Conclusion: Liver cirrhosis is a frequent pathology in the hepato-gastroenterology department of the hospital Aristide Le Dantec in Dakar. It affects young male adult. Hepatitis B virus is the leading cause. TDF is an effective treatment.

关键词： Cirrhosis Viral Hepatitis B Portal Hypertension Liver Failure Hepatomegaly

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Hepatitis C: Epidemiological, Clinical and Therapeutic Aspects in Dakar (Senegal)

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Open Journal of Gastroenterology 2022年第4期12卷 98-106页

作者： Salamata Diallo Mariéme Polele Fall marie louise bassène Mamadou Ngoné Gueye Mame Aissé Thioubou Cheikh Ahmadou Bamba Cissé Alioune Badara Fall Abdoul Aziz Atteib Fall Alsine Yauck Cheikh Anta Diop University of Dakar Hospital Aristide Le Dantec Dakar Senegal Cheikh Anta Diop University of Dakar Hospital Idrissa Pouye Dakar Senegal Assane Seck University of Ziguinchor Hospital de la Paix Ziguinchor Senegal

Viral hepatitis C is a major public health problem. The aim of our work was to determine the epidemiological, diagnostic and treatment profiles of patients with HCV in Dakar (Senegal). We conducted a retrospective, descriptive, multicentre study between January 1, 2010, and December 31, 2019. We included 26 patients. The mean age of the patients was 53.5 years [28 - 70 years] and 46.2% were males. Of the 26 patients included, 7 (26.9%) were Senegalese, and the majority were from other African countries. Risk factors for contamination found were surgery in 11 patients (42.3%) and blood transfusion in 1 patient (3.8%). The mean viral load was 6.47 log IU/ml [4.26 - 7.26 log IU/ml]. Ten patients were infected by genotype 4. No patients were co-infected with HIV or HBV. Six patients (23.1% of patients) had significant fibrosis, of which five (19.2% of patients) were in the stage of cirrhosis. Twelve patients (46.2%) started treatment. Eleven were treatment-naïve and 1 did not respond to ribavirin-pegylated interferon-based therapy after 48 weeks. Ten cases of antiviral therapy were based on DAA and ribavirin-pegylated interferon in 2 patients. For the patients treated with peginterferon and ribavirin, a rapid virologic response was observed at 12 weeks in one patient, and the other patient was lost to follow-up. Among DAA-treated patients, 7 had sustained virologic responses at 12 weeks, 2 persisted, and 1 was lost to follow-up. Moderate thrombocytopenia and weight loss were observed in one patient receiving peginterferon and ribavirin. In our study, no patient died on treatment and no patients developed de novo HCC during or after DAA therapy. Conclusion: Viral hepatitis C is rare in Senegal. Despite the progress made in the therapeutic management of viral hepatitis C, it remains a challenge in Senegal. Indeed, DAAs are expensive and are not marketed, which makes them inaccessible to most patients.

关键词： Hepatitis C Epidemiology Diagnosis Treatment Senegal

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Acute Pancreatitis during SARS CoV 2 Infection

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Open Journal of Gastroenterology 2023年第1期13卷 28-32页

作者： marie louise bassène Marième Poléle Fall Alioune Badara Fall Salamata Diallo Coumba Kouba Cissé Téné Sidibé Aï ssé Thioubou Mamadou Ngoné Gueye Hô pital Aristide Le Dantec Avenue Pasteur Dakar Sénégal Hô pital de la Paix Ziguinchor Sénégal Hô pital Général Idrissa Pouye Dakar Sénégal

Introduction: Covid-19 is a systemic disease that can spread to all systems. Among the gastrointestinal manifestations, pancreatic involvement can have a major prognostic impact. We report 3 acute pancreatitis cases occurring during Covid-19, in Dakar. Case 1: 65-year-old woman who presented with intense atypical epigastric pain. Physical examination revealed obesity, high blood pressure and abdominal tenderness. Biological tests found increase CRP (134 mg/l) and lipasemia (312 UI/l). Abdominal CT scan showed findings of Balthazar grade C acute pancreatitis. RT-PCR for SARS CoV 2 RT-PCR was positive. The outcome was favorable. Case 2: 56-year-old woman patient with history of nephroangiosclerosis who presented with dyspnea, cough, fever and moderate epigastric pain. Physical examination revealed epigastric tenderness, high blood pressure, anuria. Biological testing, noted increase CRP (96 mg/l), lipasemia (793 UI/l), creatinine (227 mg/l) and urea (3.84 g/l). Abdominal CT scan showed acute edematous pancreatitis findings. SARS CoV 2 RT PCR was positive. The outcome was favorable. Case 3: 27-year-old man who presented with physical asthenia, headache, and epigastric pain. Physical examination found epigastric tenderness. Elevated CRP level was of 102 mg/l and lipasemia level was of 427 UI/l (7N). Abdominal CT scan showed acute edematous pancreatitis findings. SARS CoV 2 RT PCR was positive. The outcome was favorable. Conclusion: Acute pancreatitis can occur during Covid-19 infection. However, the imputability to the Covid-19 disease necessitates to rule out the most common causes.

关键词： Acute Pancreatitis SARS CoV 2 Covid-19

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Benign Stenosis of Oesophagus: About 101 Cases in the Digestive Endoscopy Department of the General Idrissa Pouye Hospital (Dakar, Senegal)

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Open Journal of Gastroenterology 2022年第1期12卷 19-26页

作者： Mamadou Ngoné Guèye Mame Anta Camara Gnagna Diouf Salamata Diallo Cheikh Ahmadou Bamba Cissé Marème Polèle Fall Mame Aïssé Thioubou marie louise bassène Daouda Dial Mouhamadou Mbengue Hepato-Gastroenterology Department The Idrissa Pouye General Hospital Dakar Senegal Hepato-Gastroenterology Department The Aristide Ledantec Hospital Dakar Senegal Hepato-Gastroenterology Department The Ziguinchor Peace Hospital Dakar Senegal

Introduction: Benign oesophageal strictures are defined as narrowing of the oesophageal lumen not related to neoplastic pathology. They are frequently encountered during endoscopic practice and are often responsible for a reduction in the quality of life of patients due to the appearance of dysphagia. In sub-Saharan Africa, little data are available on these benign esophageal strictures. The objective of our study was to determine the sociodemographic, diagnostic and therapeutic aspects of benign oesophageal strictures in a digestive endoscopy centre in Senegal. Patients and Methods: This was a retrospective, descriptive study analysing reports of upper GI endoscopies performed between January 2015 and December 2017 in a hospital in Senegal. Reports that concluded to have non-neoplastic oesophageal stenosis were collated. Sociodemographic data, indications for and results of endoscopy, and therapeutic modalities were collected. These data were analysed using the Sphinx version 5 software. Results: We collected 101 cases of benign oesophageal stenosis, representing a prevalence of 2.1% in the endoscopy centre. The mean age of the patients was 34 years (range 2 and 83 years) with a median of 37.9 years. There was a female predominance with a sex ratio of 0.38 (73 females). Dysphagia, the main symptom, was present in 87 patients (86

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Evaluation of Three <i>Helicobacter pylori</i>Eradication Protocols in a Digestive Endoscopy Center in Dakar

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Open Journal of Gastroenterology 2021年第11期11卷 244-254页

作者： Salamata Diallo marie louise bassène marieme Polele Fall Alia Issa Mame Aisse Thioubou Department of Gastroenterology and Hepatology Hospital Aristide Le Dantec Dakar Senegal Department of Gastroenterology and Hepatology Hospital de la Paix Ziguinchor Senegal

Introduction: The treatment of Helicobacter pylori (H. pylori) requires the combination of antibiotic therapy with an antisecretory agent. Due to increasing antibiotic resistance, which varies from one geographical region to another, several eradication protocols exist. Objective: The objective is evaluate and compare the efficacy of three treatment regimens for H. pylori infection: 1) Arm A: Omeprazole + Amoxicillin + Clarithromycin for 10 days;2) Arm B: Omeprazole + Amoxicillin + Metronidazole for 10 days;3) Arm C: Sequential treatment = Omeprazole + Amoxicillin for 5 days then Omeprazole + Clarithromycin + Metronidazole for 5 days. Patients and Method: This was a prospective randomised study conducted from February 2016 to July 2016 and from April 2017 to September 2017 in the digestive endoscopy center of the gastroenterology and hepatology department of the University Hospital Center Aristide Le Dantec. Our study population consisted of all patients aged 18 years or older referred for upper GI endoscopy. We included all patients whose indication for the examination was epigastralgia and/or dyspepsia and whose rapid urease test was positive. Patients were randomized to the different treatment arms. A 13C-urea breath test was performed at least 4 weeks after stopping antibiotics and 2 weeks after stopping proton pump inhibitor (PPI). Results: We included 120 patients. There were 95 women and 25 men. The mean age was 40 years. Epigastralgia and dyspepsia were present in 90% and 59% of cases, respectively. Upper GI endoscopy showed peptic ulcer in 19.2% and gas

关键词： Helicobacter pylori Epigastralgia Dyspepsia Antibiotics Resistances

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Portal Thrombosis: Clinical, Etiological and Therapeutic Aspects in the Hepato-Gastroenterology Department of the Aristide Le Dantec Hospital in Dakar (Senegal)

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Open Journal of Gastroenterology 2021年第11期11卷 220-229页

作者： Salamata Diallo Coumba Ndaw Diagne marie louise bassène Mamadou Ngoné Gueye Mariéme Polele Fall Mame Aissé Thioubou Cheikh Ahmadou Bamba Cissé Daouda Dia Hôpital Aristide Le Dantec Dakar Sénégal Dakar Senegal Hôpital Idrissa Pouye Dakar Sénégal Dakar Senegal Hôpital de la paix Ziguinchor Sénégal Dakar Senegal

Background: Portal thrombosis (PT) is a rare pathology. Its prevalence is estimated at 1%. Its consequences depend on the acute or chronic nature, the extent of the clot and the etiology. In Sub-Saharan Africa, very few studies have been devoted to it. Patients and Method: The objective of our work was to determine the prevalence of PT and to describe its clinical and etiological presentation as well as its therapeutic management in the Hepato-gastroenterology department of the Aristide Le Dantec hospital in Dakar. This was a retrospective, longitudinal and descriptive study during the period from January 1, 2012, to December 31, 2018. It included all patients followed in ambulatory or inpatient, who presented a PT objectively determined by a medical imaging examination (ultrasound and/or CT scan). Age, gender, clinical and radiological aspects, proposed treatments and etiology of PT were collected. Results: We collected 71 observations. The prevalence of PT was 1.9%. The mean age of the patients was 41 years 15 and 75 years. A predominance of men was found with a sex ratio of 2.73. The clinical manifestations were dominated by abdominal pain (74.6%), ascites (35.7%) and gastrointestinal bleeding (25.4%). Imaging allowed the diagnosis to be made in 50 patients on ultrasound and 21 patients on abdominal CT scan. PT was acute in 5 patients and chronic in 66 patients. Thrombosis was complete in 71.4% of cases and extended to the spleno-mesaraic venous trunk and the superior mesenteric vein in 2.8% and 8.4% respectively. Etiological research found cirrhosis complicated by hepatocellular carcinoma in 67.6% of cases, cirrhosis with cruoric thrombosis in 21.1% of cases, a combined protein C and S deficiency in 1.4% of cases. No aetiology was objectified in 9.9% of cases. Treatment with beta-blockers was initiated in 32 patients. Anticoagulant treatment was performed in one patient. Evolutionarily, no recurrence of bleeding was noted

关键词： Portal Thrombosis Cirrhosis Portal Hypertension

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Ulcerative Colitis in Sub-Saharan Africa: Analysis of 24 Cases in Dakar (Senegal)

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Open Journal of Gastroenterology 2020年第6期10卷 128-136页

作者： Mamadou Ngoné Gueye Sokhna Niang Diop Salamata Diallo Gnagna Diouf Cheikh Ahmadou Bamba Cissé Marème Polèle Fall Mame Aissé Thioubou marie louise bassène Daouda Dia Mouhamadou Mbengue Department of Gastroenterology Idrissa Pouye General Hospital (Former Grand Yoff General Hospital) Dakar Senegal Cheikh Anta Diop University Dakar Senegal Department of Gastroenterology Aristide Le Dantec Hospital Dakar Senegal Department of Gastroenterology Peace Hospital Ziguinchor Senegal

Introduction: The aim of our study was to determine the socio-demographic, diagnostic and therapeutic aspects of ulcerative colitis (UC) in one of the largest gastroenterology departments in Senegal. Patients and Method: This was a retrospective and descriptive study based on the analysis of the records of patients hospitalized in the Hepato-Gastroenterology Department of the Grand Yoff General Hospital (Dakar, Senegal) between January 2013 and December 2019. All cases of UC were collected. Clinical, biological, endoscopic and histological data were collected, as well as treatment options. Results: We observed 24 cases, representing a prevalence of 0.87% of inpatients. The mean age of patients was 36 (ranged 18 to 73) and sex ratio 0.9 (13 females). The mean diagnostic delay was 1.6 years (ranged 4 months to 5 years). The clinical symptomatology was dominated by diarrhea with blood and mucus (18 cases). The Litchiger score on admission averaged 8 and 5 patients (20.8%) had severe acute colitis. Colonoscopy showed pancolonic involvement (Montreal E3) in 11 cases (45.8%) and severe endoscopic lesions (stage 3 of the Mayo endosc

关键词： Ulcerative Colitis Sub-Saharan Africa Toxic Megacolon 5 ASA Azathioprine

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Indications and Results of Lower Gastrointestinal Endoscopy in a Regional Hospital Center in Senegal

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Open Journal of Gastroenterology 2023年第1期13卷 43-48页

作者： Marième Polèle Fall marie louise basséne Salamata Diallo Mamadou Ngoné Gueye Cheikh Ahamadou Bamba Cissé Madoky Magatte Diop Daouda Dia Mouhamadou Mbengue Department of Gastroenterology and Hepatology Aristide Le Dantec Hospital Dakar Senegal Department of Gastroenterology and Hepatology General Hospital Idrrisa Pouye Dakar Senegal Department of Internal Medecine Regional Hospital Center of Thiès Thiès Senegal

Introduction: Gastrointestinal endoscopy plays a crucial role in the management of gastrointestinal diseases. The aim of this study was to report the indications and results of lower digestive endoscopy in a hospital center in Senegal. Patients and Methods: We conducted a descriptive retrospective study from September 1st, 2017, to September 30, 2018 at the gastrointestinal endoscopy unit of the regional hospital center of Thiès. All patients received for lower gastrointestinal endoscopy and whose reports were usable, were included. In the reports, we collected and analyzed sociodemographic data, indication and results of the endoscopic examination. Results: We included 250 patients. There were 140 men (sex ratio 1.27). The average age was 42 years [range 1 - 92 years]. There were 37 colonoscopies (14.8%), 51 rectosigmoidoscopies (20.4%) and 162 anorectoscopies (64.8%). The patients were from the region of Thiès in 82% of cases. In most cases, they were most often referred by general practitioners (22.8%) and surgeons (20.8%). The main indications were rectal bleeding (36.8%), hemorrhoidal disease (23.2%) and proctalgia (11.6%). Hemorrhoidal disease (63.6%), anal fistula (14%) and tumors (8.8%) were the most common pathologies. Conclusion: Admitted patients at the gastrointestinal endoscopy unit of the regional hospital center of Thiès have many indications as well as pathologies. Anal pathology is dominated by hemorrhoidal disease.

关键词： Lower Gastrointestinal Endoscopy Rectal Bleeding Hemorrhoidal Disease

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基于旅游者视角的世界遗产文化与自然融合价值认知研究——以桂林喀斯特为例

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浙江大学学报（人文社会科学版） 2024年第1期54卷 112-128页

作者：张柔然 [英]王家宁玛丽·路易斯·斯蒂格·索伦森剑桥大学麦克唐纳考古研究所剑桥CB23ER 深圳大学建筑与城市规划学院广东深圳518060 约克大学考古系约克YO17EP

现有的世界遗产体系中,遗产的文化和自然融合价值评估标准仍不完善。以遗产思辨研究为分析框架,挖掘多元的利益相关者对融合价值的理解,有助于填补相关评估标准的空白。在中国的文化背景中,桂林山水的自然与文化价值相互融合、相辅相成... 详细信息

现有的世界遗产体系中,遗产的文化和自然融合价值评估标准仍不完善。以遗产思辨研究为分析框架,挖掘多元的利益相关者对融合价值的理解,有助于填补相关评估标准的空白。在中国的文化背景中,桂林山水的自然与文化价值相互融合、相辅相成,游客在游览过程中能够自我理解、阐释和创造桂林山水的文化与自然融合价值。游客不仅是桂林山水文化的体验者,更是其文化价值的创造者。他们的亲身感受与理解,证实并塑造了桂林的自然与文化价值。游客的话语为重新审视遗产的文化与自然价值提供了中国旅游者的智慧,强调在评估遗产价值时应采取更加民主的方式,尊重本土知识,并以文化与自然融合的视角解读遗产价值。确保民众的话语权对于全面理解和阐释遗产价值以及制定更加合理的世界遗产保护、申报和管理策略具有至关重要的意义。

关键词：遗产思辨研究文化与自然融合价值桂林喀斯特话语分析

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Pancreatic function,quality of life and costs at long-term follow-up after acute pancreatitis

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World Journal of Gastroenterology 2010年第39期16卷 4944-4951页

作者： Bodil Andersson marie-louise Pendse Roland Andersson Department of Surgery Clinical Siences LundLund University Lund University Hospital

AIM:To evaluate long-term endocrine and exocrine pancreatic function,quality of life and health care costs after mild acute pancreatitis and severe acute pancreatitis(SAP).METHODS:Patients prospectively included in 2001-2005 were followed-up after 42(36-53)mo.Pancreatic function was evaluated with laboratory tests,the oral glucose tolerance test(OGTT),fecal elastase-1 and a questionnaire.Short Form(SF)-36,was completed.RESULTS:Fourteen patients with a history of SAP and 26 with mild acute pancreatitis were included.Plasma glucose after OGTT was higher after SAP(9.2 mmol/L vs 7.0 mmol/L,P=0.044).Diabetes mellitus or impaired glucose tolerance in fasting plasma glucose and/or 120 min plasma glucose were more common in SAP patients(11/14 vs 11/25,P=0.037).Sick leave,time until the patients could take up recreational activities and time until they had recovered were all longer after SAP(P ne pancreatic function was affected,especially after severe disease.SAP requires greater resource use with long recovery,but most patients regained a good quality of life.

关键词： Acute pancreatitis Endocrine function Exocrine function Quality of life Cost

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