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Reasons for Elective Surgery Cancellations in a Senegalese Pediatric Surgery Department

Open Journal of Pediatrics 2024年第5期14卷 783-789页

作者： Cheikh Tidiane Mbaye Cheikh Diouf Florent Tshibwid A Zeng Faty Balla Lô Lissoune Cissé Doudou Gueye Ibrahima Bocar Wellé Souleymane Camara Papa Alassane Mbaye oumar ndour Gabriel Ngom Department of Pediatric Surgery Aristide Le Dantec University Teaching Hospital Universit Cheikh Anta Diop Dakar Senegal Department of Pediatric Surgery Ziguinchor Regional Hospital Center Universit Cheikh Anta Diop Ziguinchor Senegal Department of Pediatric Surgery El Hadj Ibrahima Niass Regional Hospital Center Kaolack Senegal Department of Pediatric Surgery Pikine National Hospital Center Dakar Senegal Department of Pediatric Surgery Albert Royer National Childrens Hospital Center Universit Cheikh Anta Diop Dakar Senegal Unit of Pediatric Surgery Department of Pediatrics Dalal Jamm National Hospital Center Dakar Senegal

Introduction: Cancellation of elective surgery is common in developing countries. This decision is difficult to make as it generates economic and organizational consequences for the healthcare facility and an additional source of stress for patients and their caregivers. This study aimed to analyze the various aspects of this medical problem. Patients and Methods: We conducted a prospective and descriptive study over six months (from January 1st, 2017, to June 30th, 2017) at the pediatric surgery department of Aristide Le Dantec University Teaching Hospital in Senegal. Results: Ninety-one cases were collected. The cancellation rate was 20.8%. Infants were affected in 36.3% of cases. Among anesthesiologists, 83.5% were residents, and 16.5% were specialists. Cancellation in nephroblastoma children with an indication for extended nephrectomy represented 15.4% of cases. Concerning reasons for cancellation, comorbidities, dominated by respiratory infections, accounted for 28.5% of cases, patient absences for 24.2%, and issues related to the anesthesiologist for 17.6%. Cancellations were avoidable in 33% of cases. Patients were responsible for cancellation in 37.4% of cases, the healthcare system in 33%, and medical reasons in 29.7%. Conclusion: Our findings suggest that one-third of cancellations could have been avoided with improvements in the healthcare system. Actions should be taken to reduce the cancellation rate in our context.

关键词： Cancellation Elective Surgery Pediatric Surgery LMICs Senegal

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Factors associated with mortality in congenital malformations of the gastrointestinal tract in a tertiary center in Senegal

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World Journal of Pediatric Surgery 2023年第1期6卷 24-29页

作者： Tshibwid A Zeng Papa Alassane Mbaye Doudou Gueye Ndèye Fatou Seck Ibrahima Bocar Wellé Rosalie Niang Youssouph Diedhiou Mbaye Fall Ndèye Aby Ndoye Aloïse Sagna oumar ndour Gabriel Ngom Department of Pediatric Surgery Albert Royer National Children’s Hospital CenterUniversitéCheikh Anta Diop Facultéde Medecine Pharmacie d'Odonto-StomatologieDakarSenegal Department of Pediatric Surgery Aristide Le Dantec University Teaching HospitalUniversitéCheikh Anta Diop Facultéde Medecine Pharmacie d'Odonto-StomatologieDakarSenegal

Objective Patients with congenital malformations(CMs)of the gastrointestinal tract(GIT)have a very high ***,the literature on the factors associated with mortality in these patients is scarce in sub-Saharan *** aim of this study is to identify independent risk factors for mortality in patients with CMs of the GIT at our pediatric surgical *** We conducted a retrospective analysis of cases with CMs of the GIT managed at a tertiary center from 2018 to *** were subdivided into two groups based on the outcomes,and variables with a significant difference were analyzed by logistic *** Our review included 226 patients,63 of whom died(27.88%).Patient age ranged from 0 to 15 *** into account statistical significance,mortality was more frequent in neonates than in older patients(57.30%vs 6.15%),in patients coming out of the Dakar area than in those from the Dakar area(43.75%vs 19.18%),in patients with abnormal prenatal ultrasound than in those with normal ultrasound(100%vs 26.67%),in premature children than in those born at term(78.57%vs 21.87%),in patients with an additional malformation than in those with an isolated malformation(69.23%vs 25.35%),and in those with intestinal,esophageal,duodenal and colonic atresia than in those with other diagnoses(100%,89%,56.25%and 50%,respectively).Referred patients died more than those who changed hospitals or came from home(55.29%vs 25%and 9.09%,respectively).On multivariable logistic regression,two independent factors of mortality were identified:presence of associated malformation[odds ratio(OR)=13.299;95%Confidence interval(CI)1.370 to 129.137]and diagnosis of esophageal atresia(OR=46.529;95%CI 5.828 to 371.425).Conclusion The presence of an associated malformation or diagnosis of esophageal atresia increases mortality in patients with CMs of the GIT in our environment.

关键词： mortality diagnosis congenital

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Scapula Fracture in a Child: Report of a Rare Injury

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Open Journal of Pediatrics 2023年第2期13卷 158-163页

作者： Florent Tshibwid A. Zeng Mbaye Fall Nankouman Konaté Faty Balla Lô Eben-Ezer Samé Souleymane Camara Aimé Lakh Faye Fall oumar ndour Gabriel Ngom Department of Pediatric Surgery Aristide Le Dantec University Teaching Hospital Cheikh Anta Diop University Dakar Senegal Department of Pediatric Surgery Albert Royer National Children’s Hospital Center Cheikh Anta Diop University Dakar Sene-gal

Scapular fracture is exceptional in children, mainly occurring after high-energy trauma. Radiologic investigations help its diagnosis and classification, which determines its management. We report the case of a 14-year-old patient admitted for blunt trauma of the left shoulder after falling from a speeding car. The diagnosis of a displaced fracture of the body of the scapula was made, and non-operative treatment was indicated and carried out for four weeks, followed by physiotherapy for another four weeks. Nine weeks after the trauma, the mobility of the affected shoulder was equivalent to that of the contralateral shoulder.

关键词： Fracture Scapula Child Non-Operative Management Case Report

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Domestic Accidents in Under-Fives: Epidemiology, Diagnosis, Management, and Outcomes

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Open Journal of Pediatrics 2022年第5期12卷 726-736页

作者： Florent Tshibwid A. Zeng Papa Alassane Mbaye Doudou Gueye Papa Mamadou Ndoye Ibrahima Bocar Wellé Ndeye Fatou Seck Mbaye Fall Ndeye Aby Ndoye Aloïse Sagna oumar ndour Gabriel Ngom Department of Pediatric Surgery Albert Royer National Children’s Hospital Centre Université Cheikh Anta Diop Dakar Senegal Department of Pediatric Surgery Aristide Le Dantec University Teaching Hospital Université Cheikh Anta Diop Dakar Senegal

Introduction: Domestic accidents are a public health problem, and under-fives are particularly affected. We report these accidents’ epidemiology, diagnosis, management, and outcomes through this study. Patients and Methods: We conducted a prospective descriptive study for four months in the Albert Royer National Children’s Hospital Center pediatric surgery department in Dakar, Senegal. Of the 149 cases of domestic accidents, 109 were included in this study. Results: Infants (59.6%) were the most affected, with a slight male predominance (50.5%). Accidents occurred on Tuesday in 22.9% of cases and the afternoon in 38.5% of cases. Playing (59.6%) was the main activity, and falling (44%) was the most found mechanism. 78.9% of accidents occurred in the house, with the bedroom (27.5%) being the most represented place. In most cases (67.9%), the consultation was done within the first 24 hours. The upper limbs (48.6%) were the most affected, and fractures (31.2%) were the most frequent injuries. The outcomes were unremarkable in 94.5% of cases, as complications occurred in five patients with three who had an infection, one a persistent limping, and the last, a dental avulsion. No mortality was recorded. Conclusion: Domestic accidents among under-fives are frequent in our environment. Compared to those in older children, they occur similarly in both sexes, more often in the bedroom, and have a better prognosis.

关键词： Domestic Accidents Under-Fives Infants Preschool Children Senegal

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Profile of Extra-Pulmonary Tuberculosis in Internal Medicine

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Open Journal of Internal Medicine 2024年第1期14卷 64-73页

作者： Mouhamed Dieng Djiby Sow Demba Diédhiou Michel Assane ndour Boundia Djiba Mouhamed Almahy Niang Matar Ndiaye oumar Boun Khattab Diouf Fatou Kiné Gadji Anna Sar Maïmouna ndour Mbaye Clinique Médicale II H&ocircpital Aristide Abass Ndao Université Cheikh Anta Diop Dakar Sénégal

Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the epidemiological, clinical, paraclinical and evolutionary aspects of extra pulmonary tuberculosis (EPT) at the Abass Ndao Hospital Center. Patients and Methods: This was a descriptive cross-sectional study conducted over a period of 11 years (January 1, 2010 to December 30, 2021). All patients with extrapulmonary tuberculosis hospitalized in the department of internal medicine during the recruitment period were included. Results: Fifty-two (52) patients were collected. The year 2019 recorded the most cases 23.08% (n = 20). The mean age of the patients was 40.56 ± 18.24 years. The age group 20 - 34 years 42.31% (n = 22) was the most represented. Females were in the majority 61.54% (n = 32) with a sex ratio (M/F) was 0.63. Housewives were in the majority 40.38% (n = 21). 60.87% of the cases (n = 14) came from a health facility. 38.46% of the cases had been infected. 21.74% (n = 9) were smokers. The reasons for consultation were dominated by fever (67.44%), AEG (62.79%) and cough (41.86%). Eighteen patients (40.91%) had fever. The mean time to consultation was 77.37 ± 90.3 days with extremes of 3 and 365 days. The median was 45 days. More than half of the patients 61.90% (n = 26) had anemia. Positive retroviral serology was noted in 21.43% of cases. All patients had a CRP greater than 6. More than half of the patients 51.92% (n = 27) had multifocal tuberculosis. The peritoneum 44.23% (n = 23) was the main organ affected. The average hospital stay was 9.8 ± 4.9 days with extremes of 1 and 19 days. All patients had received the protocol in force at the national level. Death was noted in 4 patients (9.52%). Conclusion: EPT is characterized in our context by a notorious diagnostic difficulty due to the multiplicity of clinical presentations, the complexity of

关键词： Extrapulmonary Tuberculosis Epidemiology Diagnosis Senegal

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Management and Outcome of Ureteropelvic Junction Obstruction in Senegalese Children

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Open Journal of Urology 2022年第11期12卷 549-555页

作者： Ibrahima Bocar Wellé Ndeye Aby Ndoye Papa Alassane Mbaye Doudou Gueye Ndeye Fatou Seck Faty Balla Lo Lissoune Cissé Anderson Safari Kibanja Florent Tshibwid A. Zeng Youssouph Diedhiou Aloï se Sagna oumar ndour Gabriel Ngom Department of Pediatric Surgery Albert Royer National Children’s Hospital Centre Université Cheikh Anta Diop Dakar Senegal Department of Pediatric Surgery Aristide Le Dantec University Teaching Hospital Université Cheikh Anta Diop Dakar Senegal

Introduction: The ureteropelvic junction obstruction is a rare congenital malformation of the upper urinary tract. We report its management and outcome at Senegal’s main pediatric surgical department. Patients and Methods: We conducted a descriptive review of all patients managed in our pediatric surgical department at Albert Royer National Children’s Hospital Centre from January 1st, 2013 to December 31st, 2017. Results: Thirty patients were included in our study. The mean age was three years. Males were more affected (sex ratio of 2.75). The prenatal diagnosis was made in 23% of cases using prenatal ultrasonography. An abdominal mass was the circumstance of discovery in 36% of cases, and lumbar contact and renal sloshing were found in 66% of cases. There was no renal function impairment in 93% of cases. Urinary tract infection occurred in 50% of cases. Ultrasonography (100%) and urinary computed tomography (56%) were used to diagnose. A temporary nephrostomy was performed in 23% of cases, and as definitive treatment, an open Anderson-Hynes procedure was performed in 96% as a nephrectomy was made in a patient. Early postoperative complications were encountered in 56% of cases: urinary tract infection (36%), surgical site infection and anastomotic stenosis (6% both), and urinoma and textiloma (both in 3%). A patient died from sepsis. After a mean follow-up of 12 months, no additional complication was reported. Conclusion: Ureteropelvic junction obstruction was frequently diagnosed late, and its management carried unneglectable morbidity in our environment. A laparoscopic approach would be a solution to improve its outcome.

关键词： Ureteropelvic Junction Obstruction Management Outcome Children Senegal

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Three Cases of Plasma Cell Leukemia

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Open Journal of Internal Medicine 2022年第3期12卷 137-144页

作者： Mouhamed Dieng Atoumane Faye Jules Dabi Gabnon Baïdy Sy Kane Maïmouna Sow Michel Assane ndour Seynabou Fall Nafi Diagne Awa Cheikh Ndao Demba Diedhiou Boundia Djiba Fatou Samba Ndiaye Maïmouna ndour Mbaye Anna Sarr Awa oumar Touré Abdoulaye Pouye Division of Internal Medicine Aristide Le Dantec Hospital Dakar Senegal Division of Internal Medicine Abass Ndao Hospital Dakar Senegal Division of Clinical Hematology Dalal Jamm Hospital Dakar Senegal Division of Biological Hematology Aristide Le Dantec Hospital Dakar Senegal

Introduction: Plasma cell leukemia (PL) is a rare lymphoproliferative disorder characterized by the monoclonal proliferation of plasma cells in the marrow and blood peripheral. It is defined by a blood plasmacytosis greater than 2 G/l or a plasma cell level greater than 20% of leukocytes. It can be primitive or secondary to multiple myeloma (MM). We reported 3 cases of PL. Observations: Case 1: A 59 years old woman with fever, anemia with 7 g/dl, hyperleukocytosis 9200/mm3, thrombopenia 86 G/l inflammatory biological syndrome with CRP at 129 mg/l, hypercalcemia at 120 mg/l, renal failure with serum creatinine at 35 mg/l, urea at 0.85 g/l and 24-hour proteinuria at 0.98 g/24h. Β2 microglobulin at 10.34 mg/l. The blood smear shows dysmorphic plasma cells at 68% and the bone marrow at 79% of dysmorphic plasma cells. The immunophenotyping of blood cells, the electrophoretic serum protein, shows PL CD38+, secondary of a MM LAMBDA. Case 2: A 65-year-old man with type 2 diabetes presented, right femoral neck, anemia, hyperleukocytosis at 22 G/l, and thrombocytopenia at 99 G/l. There was no hypercalcemia, or kidney failure. The blood smear showed 28% of plasma cells and 9% of blasts. On the myelogram, the marrow was normal richness with significant medullary plasmacytosis (31%) made up of dysmorphic plasma cells. The CT scan showed a settling of the body of D5 with heterogeneous osteocondensation. The patient was transferred to hematology where she was treated with polychemotherapy. The evolution was unfavorable following a death due to malignant hypercalcemia. Case 3: A 62-year-old woman who had a 5-year follow-up of Ig G kappa multiple myeloma was treated with Melphalan, Prednisone, and thalidomide with a therapeutic break for 2 months. She came back to the Internal Medicine department with: severe global dehydration, anemia with externalized bleeding gingivorrhagia, pain in mechanical bones of the ribs, lower limbs, and pelvis, bilateral pneumonia. The biology

关键词： Plasma Cell Leukemia Multiple Myeloma

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Hypospadias: Evaluation of Therapeutic Outcomes and Sexual Function in Adulthood in a University Hospital Setting

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Open Journal of Urology 2020年第9期10卷 245-252页

作者： El Hadji Malick Diaw Modou Ndiaye Ousmane Sow Abdoulaye Ndiath Alioune Sarr Boubacar Fall Babacar Sine Aboubacar Traore bdourahmane Ndong Cyrille Ze Ondo Amath Thiam oumar Gaye Ndiaga Seck ndour Ngor Mack Thiam Yaya Sow Babacar Diao Papa Ahmed Fall Alain Khassim Ndoye Urology-Andrology Department Aristide Le Dantec Hospital Dakar Senegal Urology-Andrology Department De la Paix Hospital Ziguinchor Senegal Departement of Surgery Gaston Berger University Saint-Louis Senegal Urology-Andrology Department Dalal Jamm Hospital Dakar Senegal

Background: Hypospadias is a congenital malformation resulting from hypoplasia of the tissues forming the ventral face of the penis. It is associated to variable degrees with an ectopic urethral meatus, a penis curvature and a sapper’s apron foreskin [1]. The incidence of this malformation varies from country to country. It is estimated at 1/300 male births in France and 0.26/ 1000 in Mexico [1]. In Senegal, the prevalence of this malformation is unknown. Hypospadias surgery has improved significantly in recent years due to a better understanding of the anatomy on the one hand and the improvement of the instruments used during surgery on the other (suture material, surgical magnification, urethral catheter of suitable size). In sub-Saharan Africa and particularly in Senegal, hypospadias surgery remains a challenge due to the unavailability of adequate equipment (lack of microsurgical instruments and surgical loupes). Objective: To evaluate the outcomes of the treatment of hypospadias by the different surgical techniques used in our center as well as their sexual function in adulthood. Patients and Methods: This is a retrospective study, including all patients operated for hypospadias between January 2009 and December 2017 in Urology-Andrology department of Aristide Le Dantec hospital. The studied parameters were: frequency, age, clinical and therapeutic aspects, and their sexual function in adulthood after treatment. The outcomes of the treatment were judged good or poor depending of the quality of penile straightening, the aesthetic appearance of the penis, the position of the urethral neo-meatus, the permeability of the urethra and the existence or not of fistula. The sexual function was assessed by the International Index of Erectile Function 15 (IIEF) score. Results: Fifty-five patients were included. The median age was 6 years (P25 = 2.8 and P75 = 13 year

关键词： Urogenital Malformation Penile Enlargement Urethroplasty Urethrocutaneous Fistula

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