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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

Prevalence and Association of Criteria of Metabolic Syndrome in a Cohort of Diabetes Type 2 in Saint-Louis

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Open Journal of Internal Medicine 2019年第3期9卷 45-51页

作者： Dia Diatou Gueye Dia Amadou Diop diagne nafissatou M. Ngouamba Blaise Ndao Awa Cheikh Pouye Abdoulaye UFR of Health Sciences Gaston Berger University Saint Louis USA Regional Hospital Center of Saint-Louis Saint Louis USA Cheikh Anta Diop University Dakar Senegal

Introduction: The metabolic syndrome is characterized by an aggregate of metabolic disorders whose coexistence in the same individual can correspond on the one hand to a common pathophysiological mechanism and on the other hand to expose the subject to an increased risk of cardiovascular diseases. The prevalence of the metabolic syndrome is increasing rapidly in both developed and developing countries, but has been poorly described in sub-Saharan Africa. Most of them reported the components of the metabolic syndrome only in isolation. Methods: This cross-sectional study carried out on a cohort of 76 patients followed at the Sait-louis regional hospital used the definition criteria of the International Diabetes Federation. Results: The average age of our patients is 56.92 with extremes ranging from 32 to 80 years old. The sex ratio is 0.49. The average duration of diabetes progression is 68 months. The prevalence of the metabolic syndrome in this population is 67.1%. Abdominal obesity and high blood pressure are the most commonly found criteria. Abdominal obesity was the most associated component of MS in both sexes followed by high blood pressure. We found relatively weak data for dyslipidemia, especially hypertriglyceridemia. HypoHD is dyslipidemia more found in our cohort: in 45% of women and 21% of men. Conclusion: The management of the metabolic syndrome therefore requires fighting against all the factors that compose it, the first of which is the accumulation of visceral fat. Lifestyle modification is the first priority for these patients facing a society where the reduction of physical activity and the enrichment of the fat diet are becoming more and more important.

关键词： Diabetes Dyslipidemia Abdominal Obesity Saint-Louis (Senegal)

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

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

Setting up a Customized Electronic Health Record System Fit for Internal Medicine in Dakar, Senegal

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E-Health Telecommunication Systems and Networks 2019年第4期8卷 35-42页

作者： Baidy S. Y. Kane Mamour Gueye Mohamed Dieng Atoumane Faye Awa Cheikh Ndao nafissatou diagne Abdoulaye Pouye Department of Internal Medicine Gynecologic and Obstetric Clinic Dakar Senegal Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Dakar Senegal

Objective: Describe the design and implementation of an electronic medical record—E-INTMED—customized for Internal Medicine in Dakar, Senegal. Methodology: This study was carried out in a public teaching hospital in Dakar Senegal. It entailed collaboration between physicians specialized in various fields in Internal Medicine and Computer Scientists to carry out the compilation of data and their electronic transcription to produce a prototype which met users’ needs. Results: E-INTMED software is structured around several hierarchical tables allowing users to register and store all relevant patients’ information. E-INTMED structures patient’s data to provide a clear overview of their medical history and users’ activity performance. E-INTMED makes medical users’ life so much easier. Users can generate and send letters and prescriptions quickly and efficiently using the customized templates which they can modify or create new ones. In addition to these capabilities, all of the features expected in an Internal Medicine EHR are handled by E-INTMED, such as lab orders and results, mechanisms for continuity of care, embedding and access to images and documents, and so much more. E-INTMED provides medical students with a number of educational, practical and administrative advantages. Conclusion: Computerization of medical records has become a necessity today. Crossing the line to Electronic medical records could help to improve medical practice and medical training.

关键词： Internal Medicine Electronic Medical Record Dakar

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

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

Difficulties in the Management of Systemic Autoimmune Diseases in Saint-Louis Du Senegal through the Analysis of a Series of 70 Observations

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Open Journal of Internal Medicine 2021年第4期11卷 258-264页

作者： Diatou G. Dia Amadou D. Dia nafissatou diagne Awa C. Ndao Cheikh T. Tall Blaise M. Ngouamba Gaston Berger Saint-Louis University Dakar Senegal Cheikh Anta Diop University Dakar Senegal Saint-Christopher University Dakar Senegal Department of Internal Medecine Saint-Louis Sénégal

Introduction: Systemic Autoimmune Diseases (SAID) long considered very rare in Africa are increasingly the subject of publications. The objective of this work is to identify the difficulties in the management of these pathologies in an internal medicine department in northern Senegal by analyzing the epidemiological, clinical-biological, therapeutic and evolutionary aspects of SAID. Methods: This was a descriptive cross-sectional study carried out in the internal medicine department of the Saint-Louis University Hospital Center. Included were all the files of patients followed in outpatient and/or hospitalization for autoimmune diseases according to the criteria of the American College of Rheumatology, during the period from January 2017 to December 2020. The data were analyzed using SPSS software version 21.0. As the study was descriptive, no statistical test was performed. Results: Out of 3800 patients, 70 presented SAID, i.e. a hospital prevalence of 1.8%. Polyarthritis was the first reason for consultation in 97% followed by skin manifestations in 8%. The patients had positive anti-nuclear autoantibodies in 88% of cases. Rheumatoid arthritis was the predominant condition (71%) followed by systemic lupus erythematosus (SLE) (15%) and undifferentiated autoimmune diseases in 10%. Eleven percent (11%) of patients had an associated autoimmune disease. Corticosteroids were used in the treatment of these conditions in 97% of cases and methotrexate was the most prescribed immunosuppressant (54%). Thirty-two percent (32%) of patients are lost to follow-up. Conclusion: SAID are diverse and under diagnosed;they are characterized by diagnostic delay above all linked to access to specialists and sometimes to the high cost of paraclinical examinations, in particular immunology. Treatment remains based primarily on corticosteroid therapy and conventional immunosuppressants in the face of the unavailabi

关键词： Systemic Autoimmune Diseases Polyarthritis Systemic Lupus Erythematosus Saint-Louis Du Senegal

Connective Tissue Diseases on the Elderly Population in Dakar Hospital Setting

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Open Journal of Internal Medicine 2022年第2期12卷 103-111页

作者： Ndao Awa Cheikh Atoumane Faye Amadou Diop Dia nafissatou diagne Diatou Gueye Dia Birame Codou Fall Michel Assane Ndour Mouhamed Dieng Maïmouna Sow Abdoulaye Pouye Department of Internal Medicine Aristide Le Dantec Hospital Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Regional Hospital of Saint-Louis Gaston Berger University Saint-Louis Senegal Department of Internal Medicine DalalJamm Hospital Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Abass Ndao Hospital Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine Aristide Le Dantec Hospital Dakar Senegal

Introduction: Immunosenescence contributes to the development of auto-antibodies. However, while the prevalence of some autoantibodies increases with age, the incidence of connective tissue diseases decreases with age. This study aims to determine the clinical and paraclinical characteristics of connective tissue diseases in the elderly population. Materials and Methods: We conducted a retrospective and descriptive study, from March 2010 to March 2021, in the Internal Medicine Department of Aristide Le Dantec Hospital, including all the medical records of patients followed up for connective tissue disease and whose symptomatology began at an age greater than or equal to 65 years. Epidemiological, clinical, paraclinical, therapeutic and evolutionary data were collected from a pre-established survey form and then processed using SPSS software. Results: Overall, 22 cases were collected out of 275 seen on consultation. They involved 16 women and 6 men, aged between 65 and 85 years with a median of 70 years. The mean duration of the clinical picture was 15.7 months with extremes of 1 and 96 months. The clinical symptoms were joint pain in 21 patients associated with dry eye and mouth syndrome in seven cases and one patient underwent isolated dry eye and mouth syndrome. Joint involvement was deforming in 13 patients. Poor general condition was noted in 20 patients. Biology showed anemia in 14 patients, hyperleukocytosis (2 patients) and thrombocytosis (5 patients). The sedimentation rate (SR) was accelerated in 9 patients and the C-reactive protein (CRP) was positive in 12 patients. Immunology showed a positive Latex test (3 patients/6), Waaler-Rose reaction (8 patients/13), anti-cyclic citrullinated peptides (anti-CCP) antibodies (11 patients/11), anti-nuclear antibodies (2 patients/4). Anti-extractable nuclear antigens (anti-ENA) antibody testing in 4 patients showed positive anti-U1RNP (1 case), anti-SSA and anti-SSB (1 case). Plain X-Rays of the hands, wrists and feet

关键词： Connective Tissue Disease Elderly Rheumatoïd Polyarthritis Sjögren’s Syndrome Dakar

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