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Assessment of Total Incapacity for Work or Incapacity in the Criminal Sense in Case of Penetrating Wounds of the Neck

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Forensic Medicine and Anatomy Research 2018年第1期6卷 1-9页

作者： El hadji Oumar Ndoye Bobo Diallo Sidy Ahmed Dia Mouhamed Manibiliot Soumah Mame Coumba Fall Mor Ndiaye Department of Forensic and Labor Medicine University Cheikh Anta Diop (UCAD) Dakar Senegal ENT Department of the University Hospital Center of Fann Dakar Senegal

Penetrating wounds of the neck are often life-threatening. The victims are exposed to vascular and laryngotracheal lesions. The purpose of this work is to report the various aspects of the management of penetrating wounds in our context and to make the medico-legal assessment of incapacity in the criminal sense or total incapacity for work. This is a retrospective study (2002-2014) on thirty-nine (39) cases of penetrating neck wounds, received at the ENT departments of the Aristide Le Dantec and Fann University Hospital Centers. Patients were predominantly male, representing 94% of cases with an average age of 27 years. Seventy (70%) of the accidents occurred in the region of Dakar. In 42% of cases, the circumstance of occurrence was a fight or an assault. The weapon used in most cases by the aggressor was a cutter or a knife. The average waiting time was 37 hours with extremes of 02 and 216 hours. Surgically, all patients had been examined under general anesthesia. In terms of lesions, 37 cases had profound cervical muscle injuries, i.e. 94%. There were 17 vascular lesions (43%). The medico-legal distribution of patients showed that among them, 10% had a total incapacity to work exceeding 21 days. The determination of total incapacity for work is an important medical procedure that requires capability and experience. The doctor must not fall into the trap of the confusion between the TIW on the criminal level and the TIW on the civil level. He must limit medically and should not make judgments.

关键词： Penetrating Neck Wounds Assessment of Total Incapacity for Work Criminal Incapacity Forensic Medicine

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油料作物和禾谷类作物产量,产量组分和生理特性的边际效应

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国外农学（油料作物） 1994年第1期 37-38,F003页

作者： hadji.,A 莫鉴国

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Etiologies and Outcome of Children with Purulent Meningitis at the Yaounde Gyneco-Obstetric and Pediatric Hospital (Cameroon)

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Open Journal of Pediatrics 2014年第4期4卷 269-275页

作者： Seraphin Nguefack Andreas Chiabi Jacob Enoh El hadji Djouberou Evelyn Mah Karen Kengne Kamga Sandra Tatah Elie Mbonda Departement of Pediatric Neurology Yaounde Gynaeco-Obstetric and Pediatric HospitalYaoundeCameroon Faculty of Medicine and Biomedical Sciences University of Yaounde IYaoundeCameroon Departement of Pediatric University of Cocody-AbidjanAbidjanCote d’Ivoire

Background: Bacterial meningitis is one of the most severe infections in infants and children. It is associated with high mortality and neurological sequelae. In order to improve the prognosis of infants and children with purulent meningitis, we decided to conduct this study whose main objective was to identify the main pathogens responsible and describe the outcome in infants and children aged 2 months to 15 years admitted for purulent meningitis at the Yaounde Gyneco-Obstetric and Pediatric Hospital (YGOPH). Method: This was a cross-sectional study with retrospective data collection and consecutive sampling. Our study was conducted from 1 January 2009 to 31 December 2013. The patients included in the study were infants and children aged from 2 months to 15 years who were admitted for bacterial meningitis at the YGOPH, confirmed by bacteriological examination of cerebrospinal fluid (CSF) with identification of the pathogen by culture or soluble antigen. The data was analyzed using SPSS Version 18.0 and Excel 2007. The Chi-square test was used to determine the association of various variables. The significance threshold was set as P 0.05. Results: We selected 171 cases of purulent meningitis who represented 1.54% of admitted patients. The sex ratio was 1.2. We noted that 45% of our patients were aged 2 months to 1 year. The main presenting complaints were fever (98.8%), seizures (44.4%) and vomiting (28.7%). Haemophilus influenzae was found in 67 children (39.2%), followed by Streptococcus pneumoniae in 54 children (31.6%) and Neisseria meningitidis in 17 children (9.9%). Acute complications (status epilepticus, coma) were seen in 33% of patients. The statistically significant (P 0.05) factors for poor prognosis were aged from 2 months to 1 year (P = 0.0004), coma (P = 0.32), intracranial hypertension (P = 0.0001), the pathogen (P = 0.0032Pneumococcus), a delay of more than three days between the onset of the disease and the treatment (P = 0.0134) and brain abscess

关键词： Bacterial Meningitis Etiologies Outcome Children Cameroon

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Perpetrators of Sexual Violence against Minors in Casamance (Senegal)

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Open Journal of Psychiatry 2023年第1期13卷 33-44页

作者： Adama Koundoul Ibra Diagne Bernadette F. Sambou Issa Wone El hadji Makhtar Ba Sokhna Seck Papa Lamine Faye Emile Badiane Psychiatric Center Ziguinchor Senegal Health Emergency Operations Center Dakar Senegal Assane Seck University Ziguinchor Senegal Fann National University Hospital Center Cheikh Anta Diop University Dakar Senegal

Introduction: The causes of sexual delinquency against children are multifactorial and the motivations that drive the perpetrators of sexual assault are diverse. Nowadays, there is still no consensus on a single portrait of child sex offenders and studies that focus on sex offenders are still rare in Senegal and Africa. Objectives: To determine the profile of the perpetrators and to identify the circumstances of sexual violence against minors in Casamance. Materials and Methods: A retrospective descriptive and analytical study from April 1, 2014 to October 31, 2019 was conducted. The study population was made up of perpetrators of sexual violence against minors whose legal proceedings were dealt with at the Ziguinchor High Court. The data were entered into an Excel spreadsheet and then analyzed using Epi InfoTM 7 software. Results: A total of 106 cases of sexual violence against minors were collected for 113 aggressors and 106 victims. Rape accounted for 66.03% of sexual violence. Male aggressors were 98.23%. Female victims accounted for 95.28%. The average age of the attackers was 32.52 years (±13.68). Offenders over the age of 35 committed the most rape (p = 0.043). The average age of the victims was 12.62 years (±3.42). Victims aged ten and over (p = 0.015) and who had a low level of education (p = 0.016) were more exposed to rape. The assault took place during the day (65.71%) and at the home of the aggressor (62.26%). Victims knew their attackers (84.47%). Victims were assaulted more than once by the same assailant (40.57%). Those aged 10 years and over (p = 0.0037) and who knew their attackers (p = 0.014) were more at risk of being repeatedly sexually abused. Conclusion: In Senegal, sexual violence against minors is perpetrated by young adult men, single, with little or no education and exercising low-income professions. Rape is the type of aggression preferred by perpetrators, most of whom were known to their victims. The policy to fight sexual vio

关键词： Sexual Violence Minors Aggressor Casamance

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Contribution to the Study of Diabetic Kidney Disease in a Sub-Saharan Environment: An Example of the Aristide Le Dantec University Hospital in Dakar

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Open Journal of Nephrology 2023年第4期13卷 339-348页

作者： Ahmed Tall Lemrabott Maria Faye Niakhaleen Keita Seynabou Diagne Moustapha Faye Bacary Ba Abdou Niang El hadji Fary Ka Nephrology Department Aristide Le Dantec University Hospital Dakar Senegal Nephrology Department Dalal Jamm National Hospital Center Dakar Senegal

Introduction: Diabetic kidney disease (DKD) is a leading cause of chronic kidney disease and dialysis admission. Few studies are available in Sub-Saharan Africa. The objective of this work was to study the epidemiological, clinical, diagnostic and therapeutic characteristics of DKD in our context. Patients and Methods: We conducted an observational, exhaustive and retrospective study focusing on diabetic patients seen in consultation or hospitalized in the Nephrology Department of at the Aristide Le Dantec University Hospital in Dakar during a period of 5 years from January 1, 2017 to December 31, 2021. Results: Of 4735 patients seen during the study period, 491 had DKD, i.e. a hospital prevalence of 10.36%. The average age was 59.1 ± 11.4 years with a sex ratio of 0.95. Type 2 diabetes predominated with 93.4%. The average duration of diabetes was 11.5 ± 7.6 years. Diabetes was associated with high blood pressure in 78.81% of cases, dyslipidemia in 23.2% of cases, active smoking in 6.7% of cases and obesity in 1.6% of cases. Renal failure was the main reason for referral 72.3%. One hundred and forty-eight patients (30.1%) had uncontrolled diabetes. Macroalbuminuria was found in 64.8% and microalbuminuria in 18.7% of cases. One hundred and eighty-five patients (37.7%) were in Stage V of kidney disease and 137 patients were in Stage III (18.1% in Stage IIIb and 9.8% in Stage IIIa). Diabetic nephropathy was the main etiology at 61.30%. Nephropathy was mixed (diabetic and hypertensive) in 18.12 cases. Renin-angiotensin-aldosterone system (RAAS) blockers were prescribed in 83.5% of patients. Conclusion: The different etiologies encountered during the study show the diversity of diabetic kidney disease. Diabetic nephropathy is not the only kidney damage that can occur in diabetics in our context.

关键词： Diabetic Kidney Disease (DKD) Microalbuminuria Diabetic Nephropathy

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Conformational Radiotherapy of Prostatic Adenocarcinoma at the Dalal Jamm Hospital, Senegal—(Retrospective Analysis of a Series of 62 Cases)

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Journal of Cancer Therapy 2020年第10期11卷 631-638页

作者： Mouhamadou Bachir Ba Amadou Ibra Diallo Fatimatou Néné Sarr El hadji Aliou Baldé Ibrahima Thiam Papa Macoumba Gaye Radiotherapy Department Dalal Jamm Hospital UCAD Dakar Senegal Preventive Medicine and Public Health Service Health and Development Institute UCAD Dakar Senegal

Aim: We endeavored to describe the epidemiological profile of prostatic cancer, and to evaluate its diagnostic and therapeutic aspects. Method: We conducted a descriptive retrospective study on the conformational radiotherapy of prostatic adenocarcinoma at the Dalal Jamm University Hospital, Senegal from June 2018 to December 2019. We included 62 consecutive patients. The average age of the patients was 68.9 years. The average consultation time was 7.6 months. Results: Symptom manifestation and high PSA triggered the diagnosis of cancer in 74.2% and 25.8% of patients, respectively. Symptoms: pollakiuria (72.3%), bone pain (8%) and erectile dysfunction (4.8%). The digital rectal examination: normal (33.8%), nodular (30.6%), induration (24.1%), and shielding (11.3%). The mean PSA level was 90.6 ng/ml. Histology: adenocarcinoma was the most common (98.6%). The Gleason score: 7 (19.4%). The majority of patients were in the high-risk group (70.9%) and 7 patients (11.2%) were metastatic at diagnosis. Therapy: first radical prostatectomy (20.9%), first-line curative radiotherapy (67.8%), adjuvant (21%) and palliative radiotherapy in 7 patients (11.2%): patients having received palliative radiotherapy had an estimated decline in symptoms of 80%. Hormone therapy was performed in 88.8% of patients, with average duration of 12.5 months. After a mean follow-up of 15 months, 59 patients were alive, including 45 cases (81.8%) in complete remission;3 patients with metastasis at the first visit (having received palliative radiotherapy) died. Conclusion:

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Effectiveness of Treatment of Chronic Viral Hepatitis C by Direct-Acting Antivirals in Togo

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Open Journal of Gastroenterology 2019年第7期9卷 125-133页

作者： Laté Mawuli Lawson-Ananissoh Aklesso Bagny Oumboma Bouglouga Laconi Kaaga Rafiou El-hadji Yakoubou Lidaw Kogoe Datouda Redah Hepatogastroenterology Unit University Hospital Campus Lomé Togo Hepatogastroenterology Unit University Hospital of Kara Kara Togo

Background: Viral hepatitis C is the second leading cause of hepatocellular carcinoma after hepatitis B in Africa and Togo in particular. The advent of direct acting antivirals has revolutionized the care and prognosis of patients infected with hepatitis C virus (HCV). Objective: To evaluate the sustained virological response (SVR) 12 weeks after oral treatment without interferon in HCV infected patients with genotypes 1 and 2. Patients and Method: Descriptive and analytical study based on the retrospective collection of data in the hepatogastroenterology unit of the University Hospital Campus of Lome (Togo) from July 11, 2016 to April 22, 2018. All patients who had a chronic viral hepatitis C with viral replication, naive, regardless of the genotype, regardless of the degree of liver fibrosis, and who had completed their treatment with direct-acting antivirals were included. Results: We recruited 84 patients, 60 of whom were infected with HCV genotype 2 (71.43%) and 24 with HCV genotype 1 (28.57%). There were 58 men and 26 women (sex ratio: 0.45). In HCV genotype 1 patients, the median age was 54.29 years and Sofosbuvir/Ledipasvir was the most used combination (62.50%). In HCV genotype 2 patients, the median age was 54.5 years and Sofosbuvir associated with Ribavirin was the most used treatment (81.66%). The virological response at the end of treatment was 100% (genotype 1) and 93.30% (genotype 2). The SVR 12 was 100% (genotype 1) and 91.70% (genotype 2). Five patients were in treatment failure (genotype 2). Conclusion: Direct-acting antivirals were effective in our patients. The rate of sustained virological response was above 90%.

关键词： Viral Hepatitis C Direct-Acting Antivirals Sustained Virological Response Togo

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Total Hip Prosthesis in Dakar and Forensic Implication

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Forensic Medicine and Anatomy Research 2018年第3期6卷 37-46页

作者： El hadji Oumar Ndoye Serigne Moussa Badiane Mohamadou M. Soumah Sidy Ahmet Dia Mame Coumba Fall Mor Ndiaye Faculty of Medicine Pharmaceutics and Odonto-Stomatology UCAD Service de Médecine Légaleet du Travail Dakar Sénégal Faculty of Health Sciences University Gaston Berger (UGB) Saint-Louis Sénégal

The total hip prosthesis is the ultimate treatment of the hip joint’s wear. It is a delicate surgery and the most common replacements. This study was performed in the Orthopaedic-Traumatology Department of Public Health Establishment of Aristide Le Dantec in Dakar. It aimed to determine the complications of our total hip and highlight their forensic implications. This is a retrospective study from patients collected from January 2000 up to December 2010. The collection of elements records was performed for each patient, based on a file including age, sex, primary-location’s etiology, and types of complications of total hip prostheses. The analysis of these complications has shown that infections, poorly lit information, poor operational planning and technical foul may be the main cause of a forensic implication. This is a retrospective study from patients collected from January 2000 up to December 2010. No lawsuit has been recorded for the complications identified in this work. This is due to the belief in fate, ignorance of the victims and solidarity of the medical profession, the high cost and slow pace of judicial proceedings. The diagnosis of total hip prosthesis complications is mainly based on imaging tests. The absence of scintigraphy in our center remains a limit to the early diagnosis of multiple complications and the proper establishment of the epidemiological profile of these lesions. Taking consciences patients of their rights encourages a legitimate requirement repair the harm inflicted.

关键词： Total Hip Replacement Forensic Implications Bone Scintigraphy Articular and Bone Imaging

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Characteristics and Prognosis of Patients with Hepatocellular Carcinoma at Campus Teaching Hospital of Lome

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Open Journal of Gastroenterology 2019年第11期9卷 203-210页

作者： Aklesso Bagny Late Mawuli Lawson-Ananissoh Oumboma Bouglouga Lidawu Kogoe Rafiou El hadji-Yakoubou Debohoma Redah Datouda Redah Hepatology and Gastroenterology Department of Campus Teaching Hospital of Lome Lome Togo Gastroenterology Unit of Teaching Hospital of Kara Kara Togo

Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, as well as in Togo, where it is a major public health problem. HCC is the third most common cause of death from cancer. Chronic infection with HBV and HCV is the most important cause of HCC. Objective: To determine the epidemiological, diagnostic and evolutionary aspects of HCC in the hepatology and gastroenterology department of Campus Teaching Hospital of Lomé. Patients and method: Descriptive and analytical study, conducted from January 1, 2013 to December 31, 2017, on all patients admitted in the hepatology and gastroenterology department of Campus Teaching Hospital of Lome for hepatocellular carcinoma. The statistical analysis was done using Stata 13 software. The significance threshold was used for p Findings: A total of 250 patients were retained. Hospital prevalence was 6.1%. There was a male predominance with a sex ratio of 2.84. The average age was 47.15 ± 13.85 (extreme: 20 - 85 years). The average duration of symptoms was 67.08 ± 82.59 days. Pain in the right hypochondrium was the most common reason for consultation (64.6%). The average AFP value was 24,062 ± 33,318 ng/ml. Ultrasound found more than two nodules in 74.75% of cases and a portal thrombosis in 64.97% of cases. The main etiologies found were chronic hepatitis B (55%) and C (8%) virus infections. The majority (89.20%) of patients were in the BCLC D stage. Survival at 6 months was 45%. Factors associated with death were: chronic ethylism (OR = 16.87, p = 0.002), jaundice (OR = 341.57, p = 0.004), rupture of esophageal varices (OR = 42.45, p = 0.008) and a BCLC D score (OR = 9.82, p = 0.041). Conclusion: Young adults were the most affected by HCC, whose etiologies are dominated in our context by hepatitis B and C viruses. The majority of our patients consulted late and was found at the terminal stage of the disease, limiting any therapeutic possibility. In this situation, the best attitude remains

关键词： Hepatocellular Carcinoma Diagnosis Survival Togo

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Contribution of <sup>99m</sup>Tc-DPD Scintigraphy in the Diagnosis of Cardiac Amyloidosis in Black Africans

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Open Journal of Biophysics 2022年第1期12卷 27-37页

作者： Djigo Mamoudou Salif Ndong Boucar Bathily El hadji Amadou Lamine Diop Ousseynou Gueye Kalidou Thiaw Gora Ndoye Oumar Mbodj Mamadou Department de Medecine Nucleaire Hô pital General Idrissa Pouye Dakar Senegal Department de Medecine Nucleaire Hô pital Dalal JAMM Dakar Senegal

Cardiac amyloidosis presents a picture of hypertrophic cardiomyopathy with heart failure with preserved ejection fraction. It is largely underdiagnosed, especially in black Africans, and therefore falls under the category of heart disease classified as idiopathic. Light chain amyloidosis (AL) is mainly found in Caucasian subjects and the mutant variant of transthyretin (TTRm) in negroid subjects. Numerous studies have shown that ATTRm was found predominantly in black American and black British patients. In African countries the entity of idiopathic heart failure is quite important because of lack of diagnosis, ETT, MRI and immuno-histochemistry are expensive or not available. We can probably assume that the proportion of cardiac amyloidosis is quite important in black Africans. The question is if 99mTc-DPD really easy to perform, can probably help to investigate in the nuclear medicine department in Africa. No large-scale study has been able to demonstrate the prevalence or not of cardiac amyloidosis in black-African subjects and by extension reduce this nosological entity of idiopathic heart disease. The 99mTc-DPD scintigraphy using Perrugini’s visual sore allows localization and classification of amyloid damage. The mechanism of binding of 99mTc-DPD to amyloid fibril deposits is not well known, its binding to TTR-type (mutated or wild type) amyloidosis is greater than the AL variant. In the diagnostic algorithm, endomyocardial biopsy is the gold standard but remains invasive, ETT with the strain allows a presumptive diagnosis and remains an operative examination dependent and is not reproducible. Cardiac MRI allows some localization of amyloid deposits but still remains less sensitive than scintigraphy. In addition, performing the whole-body MRI is very restrictive (time, antenna change and cost). The aim of this literature review was to show the superiority of 99mTc-DPD scintigraphy compared to other diagnostic modaliti

关键词： Amyloidosis TTRm AL 99mTc-DPD Bone Scintigraphy

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