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Neuroanatomical Basis of Postoperative Pain and Assessment of Its Management in a Series of Patients Undergoing Caesarean Sections

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Pain Studies and Treatment 2024年第2期12卷 21-32页

作者： moustapha diedhiou Philippe Manyacka Ma Nyemb Ndiamé Sarr Aissatou Sarr Ousmane Thiam Mohamed Lamine Fall Health Sciences Training and Research Unit Gaston Berger Saint Louis University Saint Louis Senegal Intensive Care Unit Saint Louis Regional Hospital Saint Louis Senegal

Introduction: In recent decades, the cost of postoperative pain has been the subject of many studies based on protocols developed by scientific societies for its assessment and optimization. At the Regional Hospital of Saint-Louis (Senegal), several protocols have been developed for pain management, but no study has focused on the assessment of postoperative pain management specifically. We therefore initiated this work, the objectives of which were to remind the neuroanatomical and neurophysiological bases of postoperative pain, and to analyze the assessment and management of this pain in patients who have undergone a caesarean section. Materials and methods: This was a prospective and descriptive study, which took place in the gynecology-obstetrics department, over a period from January 2019 to July 2020. All patients who gave birth by cesarean section were included. The data was collected from a survey sheet written for this purpose. For each of the patients, the information was taken every day throughout the duration of postoperative hospitalization. Results: It appears from our work that after a cesarean section, the pain felt evolves on the first postoperative days with a peak during the second day. As in the data reported in the literature, there does not seem to be a difference in terms of pain intensity and analgesia dosage between scheduled and emergency caesarean sections. However, young age and female gender—for other types of surgeries—are risk factors associated with high postoperative pain scores. This trend is probably related to the low pain experience of tested patients. Our initial hypothesis was that acute post-operative pain after caesarean sections could be linked to defects in the perception and processing of pain by caregivers. Indeed, we have shown that awareness-raising, information, and training actions have made it possible to significantly improve the management of pain after a cesarean section. Conclusion: After a cesarean section the p

关键词： Postoperative Pain Neuroanatomical Bases Assessment Cesarean Section

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Profile of SARS-CoV-2 Infected Patients Hospitalized at the Epidemic Treatment Center (ETC) in Saint-Louis, Senegal during the First Two Waves

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Advances in Infectious Diseases 2024年第2期14卷 322-337页

作者： Alassane Dièye Papa Latyr Junior Diouf Bourama Diémé moustapha diedhiou Diatou Dia-Gueye Amadou Diop Dia Samba Niang Ibrahima Louis Martin Dieng Ameth Dieng Seynabou Lô Ndéye Méry Dia-Badiane Health Sciences Training and Research Unit Gaston Berger University Saint-Louis Senegal Emergency Department of Regional Hospital Center Saint-Louis Senegal Department of Infectious and Tropical Diseases of Fann Dakar Senegal

Introduction: The SARS-CoV-2 infection is a major public health emergency. Several risk factors are involved in the occurrence of respiratory distress that can lead to death despite resuscitation measures. Objectives: The aim of this study was to describe the epidemiological, clinical, paraclinical, therapeutic, and evolution profile of patients infected with SARS-CoV-2 hospitalized at the CTE of Saint-Louis (Senegal) during the first two waves. Patients and Methods: We conducted a retrospective, cross-sectional, descriptive, and analytical study that included all patients hospitalized at the ETC of Saint-Louis (Senegal) with SARS-CoV-2 infection from March 2020 to April 2021. Results: A total of 358 cases were collected, 256 (71.5%) during the first wave and 102 (28.5%) during the second wave. The mean age was 49.5 years (19.5). There was a male predominance (58.4%), with a sex ratio of 1.4. Hypertension was the main comorbidity, with 87 cases (24.3%). The most common functional signs were cough in 194 cases (54.2%), dyspnea in 143 cases (40%) and ageusia in 134 cases (37.4%). Thoracic CT scans were performed on 20 patients (5.6%), with severe involvement (50% - 75%) observed in 50% of cases. Hydroxychloroquine-azithromycin was prescribed to 351 patients (98%). Overall, 338 (94.4%) recovered and 17 (4.7%) died. In multivariate analysis, factors associated with death were male sex [OR = 2.645;95% CI: 1.530 - 4.785;p = 0.011], age 60 years [OR = 1.039;95% CI: 0.564 - 1.914;p = 0.002], the presence of comorbidities [OR = 2.171;95% CI: 0.564 - 3.429;p = 0.033], SpO2 (ambient air) 95% [OR = 2.061;95% CI: 0.616 - 3.827;p = 0.03], acute respiratory distress syndrome (ARDS) [OR = 0.635;95% CI: 0.316 - 1.275;p = 0.001], severe form [OR = 1.664;95% CI: 0.298 - 2.478;p = 0.016], occurrence of complications [OR = 0.521;95% CI: 0.287 - 0.944;p = 0.032], high creatinine levels [OR = 2.061;95% CI: 1.616 - 3.827;p = 0.026], and lymphopenia [OR = 0.485;95% CI: 0.370 - 0.636;p = 0.0

关键词： SARS-CoV-2 Saint-Louis Senegal

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COVID-19/Tuberculosis Co-Infection at the Epidemic Treatment Center (ETC) of Saint-Louis (Senegal): About 9 Cases

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Advances in Infectious Diseases 2024年第1期14卷 56-66页

作者： Alassane Dièye moustapha diedhiou Papa Latyr Junior Diouf Mba Bambo Diakhaby Demba Makalou Samba Niang Diatou Dia-Gueye Amadou Diop Dia Ibrahima Louis Martin Dieng Seynabou Lô Ndéye Méry Dia-Badiane Health Sciences Training and Research Unit Gaston Berger University Saint-Louis Senegal Department of Medicine Saint-Louis Regional Hospital Saint-Louis Senegal Infectious and Tropical Diseases Clinic of Fann Dakar Senegal

Introduction: COVID-19 is a global public health emergency that can cause acute respiratory distress syndrome. In countries where tuberculosis (TB) is endemic, coinfection of COVID-19 and TB is often encountered, which increases the risk of developing severe forms of COVID-19. Objectives: The aim of this study was to determine the prevalence of COVID-19/TB coinfection at the Epidemic treatment center (ETC) in Saint-Louis (Senegal) and to describe the epidemiological, clinical, paraclinical, and outcome profile of co-infected patients. Patients and Methods: This is a retrospective, cross-sectional, descriptive cohort study based on the records of COVID-19/ TB co-infected patients who were hospitalized at the ETC in Saint-Louis (Senegal) over an 18-month period from March 2020 to September 2021. Results: Out of a total of 454 hospitalizations, we collected records of 9 patients co-infected with COVID-19/TB, resulting in a prevalence of 2%. The study included patients with a median age of 34 years (range: 10-86 years), with a male predominance (7 cases) and a sex ratio of 3.5. The majority of patients (88.9%) had severe forms of COVID-19. Dyspnea and cough were reported in all patients (100%). Pulmonary TB was the most frequent localization, with 9 cases. The diagnosis of COVID-19 was confirmed by nasopharyngeal PCR in all patients (100%). Bacilloscopy was positive in 3 out of 5 cases. One patient tested positive for GeneXpert? MTB/RIF without rifampicin resistance. All patients were prescribed the hydroxychloroquine-azithromycin combination and anti-tuberculosis treatment. Out of the nine patients, four recovered (44.4%) and five died (55.5%). Conclusion: COVID-19/TB coinfection had a low prevalence in our cohort, but was associated with a high mortality due to the frequent occurrence of severe forms of the disease.

关键词： COVID-19 Tuberculosis Saint-Louis Senegal

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Postoperative Analgesia for Abdominal Laparoscopic Surgery: Tap Block vs Peri-Orificial Infiltrations

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Open Journal of Anesthesiology 2023年第10期13卷 187-196页

作者： moustapha diedhiou Ndiamé Sarr Elhadji Boubacar Ba Abdourahmane Ndong Fallou Galass Niang Jacques Noel Tendeng Ibrahima Konaté Mohamed Lamine Fall Health Sciences Training and Research Unit (UFRSS) Gaston Berger University Saint Louis Senegal Faculty of Medicine and Pharmacy Cheikh Anti Diop University Dakar Senegal

Introduction/Purpose: The “transverse abdominal plane block” or TAP block was described by Rafi in 2001. It describes an approach to the neurofascial plane of the transverse abdominal muscle via the Jean-Louis Petit triangle and provides analgesia of the entire homolateral hemi abdomen. The aim of our study was to compare post-operative analgesia and post-operative morphine requirements between transverse abdominal plane block (TAP) and peri-orificial infiltration during laparoscopic abdominal surgery. Material and method: Prospective, randomized study conducted over a 2-year period. The study was conducted in the operating theatre of the Saint Louis Regional Hospital in Senegal. All adult patients undergoing laparoscopic abdominal surgery were included. Clinical aspects, pain scales and morphine consumption were analyzed. Results: A total of 60 patients were enrolled: 30 patients in the TAP group and 30 patients in the infiltration group. The average age was 32.9 years. The indications for laparoscopy were acute appendicitis in 50% of cases, gallbladder stones in 16% and inguinal hernia in 8%. For the TAP group, the mean numerical pain scale was 3.9 at 6 hours post-operatively and 2.1 at 24 hours post-operatively. For the infiltration group, the mean numerical pain scale was 4.3 at 6 hours post-op and 3 at 24 hours post-op. Morphine consumption at 6 hours post-op was on average 0.4 mg/patient for the TAP group and 0.9 mg/patient for the infiltration group. Discussion/conclusion: Analgesia provided by ultrasound-guided TAP block for laparoscopic abdominal surgery appears to be identical to periorificial infiltration. However, the simplicity and reproducibility of ultrasound-guided TAP block gives it a definite advantage.

关键词： Loco-Regional Anesthesia Post-Operative Analgesia Infiltrations Laparoscopy TAP-Block

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Laryngeal Cancers at the Pathological Anatomical Laboratory (ACP) in Dakar about 215 Cases

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Open Journal of Pathology 2023年第2期13卷 79-86页

作者： Marie Joseph Dieme Ahouidi Adama diedhiou Abdou Magib Gaye Dibor Niang Falilatou Seidou Ibou Thiam Cherif Mouhamed moustapha Dial Anatomy and Pathological Cytology Laboratory Fann Hospital Dakar Sénégal Anatomy and Pathological Cytology Laboratory Aristide Le Dantec Hospital Dakar Sénégal Anatomy and Pathological Cytology Laboratory Gaston Berger University St Louis Sénégal Anatomy and Pathological Cytology Laboratory Idrissa Pouye Hospital Dakar Sénégal

Introduction: Laryngeal cancer is the first cancer of upper aerodigestive tract. Dysphonia, dyspnea and dysphagia are evocative signs. Diagnosis is histological and squamous cell carcinoma is the most common type. The objective of our study was to discuss epidemiological and anatomo-pathological characteristics of laryngeal cancers diagnosed in different pathological anatomy and cytology (ACP) laboratories of Dakar hospitals. Material and method: This was a retrospective study spanning from January 2013 to December 2018 at the pathological anatomy laboratories of Fann, Aristide Le Dantec and Idrissa Pouye hospitals. All patients with laryngeal cancer confirmed at histology were included. Data collection was based on clinical records of the patients and archives of histological reports of the pathological laboratories. Data analysis was performed under the Excel software. Results: We collected 215 cases of laryngeal cancer. The average age was 58.01 years with extremes of 07 and 94 years. The male sex was predominant with 183 patients (85.12%) against 32 women (14.88%). The most noted risk factor was tobacco which affected 14 patients, or 60.87%. Three patients (13.04%) did not present any alcohol-smoking impregnation. Clinically, dysphonia was noted in 22 patients (26.51%). It was associated with dyspnea in 0.48% of cases and dysphagia in 3.61%. Laryngoscopy was performed in 62 patients or 28.83% of cases, nasofibroscopy in 6.45% of cases. Cord arythenoid fixity was noted in two patients (3.23%) and hypo-mobility in 1 patient (1.61%). The most frequent local extension was involvement of the piriform sinus with 11.29% of cases. Palpable lymphadenopathy reported in 17 patients (20.48%). Pathological examination was performed in all patients after post endoscopic biopsy in 92 patients (42.79%), and after obtaining the operative specimen in 123 cases (57.21%). The three floors affected 76 patients (35.35%). The ulcerative budding aspect most noted concerned 108 patients

关键词： Laryngeal Cancer Carcinoma Dakar

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Association between Hyperhomocysteinemia and Microangiopathic Complications (Neuropathy and Nephropathy) in Subjects with Type 1 and Type 2 Diabetes

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Journal of Diabetes Mellitus 2023年第4期13卷 325-339页

作者： Nene Oumou Kesso Barry Soukeyna Gueye moustapha Djité Pape Matar Kandji Michel Assane Ndour El Hadj Malick Ndour Demba diedhiou Fatou Gueye-Tall Ndeye Mareme Thioune Najah Fatou Coly Dominique Doupa Maïmouna Ndour Mbaye Philomène Lopez Sall Papa Madieye Gueye Laboratory of Pharmaceutical Biochemistry University Cheikh Anta DIOP Dakar Senegal Laboratory of Biochemistry University Hospital Fann Dakar Senegal Department of Internal Medicine Abass Ndao Hospital Center Dakar Senegal Medical Biology Laboratory Diamniadio Children Hospital Dakar Senegal Department of Medical Biochemistry Saint-Louis University Saint-Louis Senegal

This prospective case-control study aimed to assess the prevalence of hyperhomocysteinemia and explore its potential correlation with microangiopathic complications, specifically nephropathy and neuropathy, in a cohort of both type 1 and type 2 diabetic patients. Conducted at the Marc Sankalé Center of Abass Ndao Hospital in Dakar from June to September 2018, the study enrolled a total of 106 diabetic patients, comprising 93 type 2 diabetics and 13 type 1 diabetics, who were matched with control subjects free from clinically detectable pathologies, based on sex and age ± 2 years. The mean age of type 1 and type 2 diabetic patients was 24.46 ± 8.41 years and 57.28 ± 11.28 years, respectively. Our findings revealed a statistically significant elevation in mean homocysteine levels among patients when compared to controls (12.63 vs. 9.88;p < 0.0001). Hyperhomocysteinemia was observed in 24.5% of the patients, exclusively among those with type 2 diabetes. Within the hyperhomocysteinemia subgroup, 58% were male, and 42% were female. The analysis of neuropathy and nephropathy frequencies among type 2 diabetic patients, stratified by homocysteine concentrations, demonstrated a notably higher prevalence of diabetic nephropathy in patients with hyperhomocysteinemia compared to those with normohomocysteinemia (23.07% vs. 8.75%;p = 0.052). Similarly, diabetic neuropathy exhibited a significantly greater frequency in patients with hyperhomocysteinemia as opposed to normohomocysteinemia (80.76% vs. 50%;p = 0.005). Furthermore, our results established a significant positive correlation between homocysteine concentrations and both age (r = 0.402;p < 0.0001) and creatinine levels (r = 0.461;p < 0.0001). Bivariate logistic regression analysis indicated that patients with hyperhomocysteinemia faced 3 times and 6 times higher risks of developing neuropathy (OR = 3.5;p = 0.061) and diabetic nephropathy (OR = 6.092;p = 0.014), respectively.

关键词： Homocysteine Hyperhomocysteinemia Diabetes Mellitus Type 1 Diabetes Type 2 Diabetes Nephropathy Neuropathy

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Laryngeal Cancers at the Pathological Anatomical Laboratory (ACP) in Dakar about 215 Cases

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Open Journal of Pathology（病理学期刊） 2023年第2期

作者： Marie Joseph Dieme Ahouidi Adama diedhiou Abdou Magib Gaye Dibor Niang Falilatou Seidou Ibou Thiam Cherif Mouhamed moustapha Dial

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