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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

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

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

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

Empty Sella Turcica Syndrome: About a Case Revealed by Adrenal Insufficiency

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Open Journal of Internal Medicine 2021年第2期11卷 68-72页

作者： Sow Maïmouna Diagne Nafissatou ndao Awa cheikh Thiam Mbaye Faye Atoumane Dieng Mouhamed Kane Baïdy Sy Djiba Boundia Pouye Abdoulaye Internal Medicine Department Aristide Le Dantec Teaching Hospital Dakar Senegal Radiology Department FANN Teaching Hospital Dakar Senegal

Background: Empty sella turcica corresponds to an arachnocele which may be complete or partial, primary or secondary. The primary form is rarer. Its cause is unknown, but etiological factors have been identified. The prevalence of this condition is variable, depending on techniques of diagnosis. It may be detected fortuitously on imaging or in the presence of neurological, ocular or endocrine manifestations. Aim: We aim to report a case of empty sella turcica syndrome revealed by adrenal insufficiency in a young African black woman. Case presentation: It was an overweight young woman with signs of intracranial hypertension associated with central adrenal insufficiency. The diagnosis of empty sella was confirmed by magnetic resonance imaging. Secondarily, she developed a hypo metabolism syndrome and biology confirmed central hypothyroidism. After correction of the adrenal cortical deficit, the treatment of the thyroid deficit was administered. Evolution was favourable clinically and biologically. Conclusion: The empty sella turcica is rare and its revelation by a central adrenal insufficiency is even more. The case we report is a perfect illustration.

关键词： Empty Sella Turcica Adrenal Insufficiency Intracranial Hypertension

Frequency of Cardiovascular Risk Factors in Systemic Lupus Erythematosus: A Case-Control Study in a Department of Internal Medicine in Sub-Saharan Africa

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Open Journal of Internal Medicine 2020年第1期10卷 1-12页

作者： Maï mouna Sow Baï dy Sy Kane Abdourahmane Samba Awa cheikh ndao Nafissatou Diagne Boundia Djiba Mouhamed Dieng Atoumane Faye Abdoulaye Pouye Internal Medicine Department Aristide Le Dantec Teaching Hospital Dakar Senegal Biochemistry Department Aristide Le Dantec Teaching Hospital Dakar Senegal

Background: The morbidity and mortality of systemic lupus erythematosus are largely due to accelerated atherosclerosis. This is partly related to the high prevalence of traditional cardiovascular risk factors. The aim of our study was to determine the frequency of these factors in lupus patients compared to a control population in a department of internal medicine. Methods: We realized a case-control study in patients with systemic lupus erythematosus according to ACR criteria in 1997. Patients were matched by age and gender with controls subjects without autoimmune disease. We studied the frequency of traditional cardiovascular risk factors in both populations. The study was done in the department of internal medicine of Aristide Le Dantec teaching Hospital, in Senegal, during the period from August 2017 to December 2018. The statistical analysis was performed with SPSS 23.0 software and the level of significance was retained for a p-value Results: We recruited 100 subjects including 50 patients and 50 controls. The mean age was 33.5 ± 11.3 years in cases and 33.3 ± 11.3 years in controls. Dyslipidemia was significantly associated with systemic lupus erythematosus (p = 0.009). Levels of triglycerides (p Conclusion: Traditional cardiovascular risk factors including dyslipidemia and hyperuricemia were more common in patients. Similarly, renal failure was associated with lupus.

关键词： Cardiovascular Risk Factors Systemic Lupus Erythematosus Sub-Saharan Africa

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