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Total Hip Prosthesis in Dakar and Forensic Implication

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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Evaluation of Access to Care for Patients with Chronic Kidney Disease Not on dialysis in Saint-Louis Region (SENEGAL)

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Open Journal of Nephrology 2020年第1期10卷 1-10页

作者： Seck sidy Mohamed Doupa Dominique Ndongo Modou Ahoui Seraphin Diop-dia Amadou dia diatou Gueye Ngouampa Blaise Magloire Enguerran Macia Internal Medicine and Nephrology Department University Gaston Berger Saint-Louis Senegal UMI 3189 Environnement santé sociétés (CNRS/Université Cheikh Anta Diop/Université de Bamako/CNRST Burkina-Faso) Faculté de Médecine de Pharmacie et d’Odontostomatologie Dakar Senegal Biochemistry Department University Gaston Berger Saint-Louis Senegal Nephrology Department Borgou Regional Teaching Hospital Parakou Benin

Introduction: Patients with chronic diseases, especially kidney diseases, frequently use the health care system and free dialysis policies are being implemented in many countries in Africa. This study aimed to evaluate access to care for patients with chronic kidney disease (CKD) in northern region of Saint-Louis. Methodology: In a cross-sectional survey, we included non-dialyzed CKD patients aged ≥20 years who attended outpatient nephrology clinic at University Hospital of Saint-Louis between January 1st and January 31st 2018. Access to care was measured using a questionnaire that integrated dimensions such as availability, geographic and financial accessibility, convenience, acceptability, effectiveness of care and quality of information. Socio-demographic and clinical data were also collected and analyzed with Epi Info 7. Results: Among 97 surveyed patients, 90 were included (response rate of 92.8%). Patients’ mean age was 35.2 years (20 - 89 years) and 55% were male. Only 30% of patients had health coverage either by the government, or private insurance or community health insurance. Access to care was rated as globally low by 73% of participants. However, we noticed some variations according to dimensions of access. Geographical accessibility and convenience of delivered care were good for the majority of patients, while financial access and acceptability of care were considered as very limited. Bivariate analysis showed that acceptability and effectiveness of care were linked to CKD stage while the quality of patients’ information was correlated with their educational level. Furthermore, health coverage was also associated with financial accessibility of care but not with its availability. Conclusion: This study showed that access to care is poor for majority of patients with CKD in Saint-Louis. Identification of the main barriers will help define appropriate strategies to achieve universal access to quality renal care.

关键词： Access to Care Chronic Kidney Disease Saint-Louis

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Epidemiology of Sleep Disorders among Chronic Hemodialysis Patients in Senegal: A Multicentric Study

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Health 2016年第1期8卷 42-48页

作者： Zeinabou Maiga Moussa Tondi sidy Mohamed Seck Elhadj Fary Ka Mouhamadou Moustapha Cisse Amadou Diop dia diatou Gueye dia Boucar Diouf Lamine Gueye Nephrology Department Faculty of Health Sciences University Abdou Moumouni Niamey Niger Faculty of Health Sciences University Gaston Berger Saint-Louis Senegal UMI 3189 “Environnement Santé Société UCAD” Dakar Senegal Nephrology Department University Hospital HALD Dakar Senegal

Introduction: Sleep disorders (SD) are common dialysis patients and can impact their quality of life. In previous studies, black ethnicity was associated with higher incidence of SD but a few data are available in African patients. This study aimed to describe prevalence and risk factors of SD among Senegalese dialysis patients. Methods: We performed a cross-sectional study between February 15th and April 30th 2012 including 127 patients (75 males and 52 females) aged 46.8 ± 16.9 (16 - 85 years) and dialysed since >6 months in three dialysis centres. For each patient, we assessed insomnia according to international definition, obstructive sleep apnea syndrome (OSAS) with the Berlin questionnaire, restless leg syndrome (RLS) using abridged version of Cambridge-Hopkins RLS questionnaire, and excessive daytime sleepiness (EDS) with Epworth sleepiness scale. Logistic multivariate regression was used to identify factors associated with different SD. Results: Overall prevalence of SD was 88% comprising: insomnia (64.3%), OSAS (49.1%), RLS (24.1%) and EDS (20.5%). Forty-two patients presented at least two disorders. No difference was noticed in prevalence of SD between genders (p = 0.14). Level of blood pressure were not different across patients with and without SD. Insomnia correlated with anemia, inflammation and EDS. OSAS was associated with age ≥50 years, EDS and neck circumference ≥25 cm. RLS correlated with anemia and EDS. Other parameters such as gender, dialysis vintage, KT/V, obesity, diabetes status and hypoalbuminemia were not associated with the different SD. The majority of patients had not been diagnosed before the survey and none of them was under treatment. Conclusions: Our findings are compatible with high prevalence of sleep disorders reported in other populations. Insomnia and OSAS are the most frequent SD but some patients combined many disorders. Nephrologists should be more aware of these SD in order to detect them early and provide efficient treatme

关键词： Sleep Disorders Hemodialysis Epidemiology Senegal

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Sudden Cardiac Death in Dakar: Epidemiological and Anatomo-Pathological Characteristics

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Forensic Medicine and Anatomy Research 2019年第3期7卷 51-61页

作者： El Hadji Oumar Ndoye Amadou Mouctar diallo Ibou Thiam Mouhamed Manibiliot Soumah sidy Ahmed dia Mor Ndiaye Forensic and Labor Medicine Department Cheikh Anta Diop Dakar University (UCAD) Dakar Senegal Forensic Department Ignace Deen Hospital Conakry Guinea

Sudden cardiac death (SCD) generally refers to sudden cardiovascular death of a person with or without pre-existing heart disease. This is a retrospective study conducted at the Department of Anatomy and Pathological Cytology at Aristide Le Dantec Hospital in Senegal. This study covers a period of 7 years from January 1st, 2000 to December 31st, 2006. During this 7-year period we collected 235 cases of sudden cardiovascular death out of a total of 3717 forensic autopsies, representing a frequency of 6.32%. Sudden cardiovascular deaths accounted for 75.3% of all 312 sudden deaths. 96.1% were black compared to 3.9% Caucasians. The average age of the patients was 46.86 years with extremes ranging from 17 to 86 years. The most affected age group was between 50 - 59 years old, representing 23.4% of the cases. The sex ratio was 4.3 in favour of men. Men aged 50 - 59 were the most affected, while women were more affected in the 20 - 29 age group. Cardiomyopathies constituted 54.9% with 90% of dilated cardiomyopathies of which 75% were male and 10% of hypertrophic cardiomyopathies more frequent also in men. Valvulopathies came in 3rd position with 3.4% of the cases and in 75% of the cases they were poly-valvulopathies. Atherosclerosis was incriminated in 2.5% of the cases and aortic localization was the most represented. Aortic dissection was implicated in 6 cases out of 235 or 2.5%. It was isolated in 4 cases (without other cardiac conditions), and in the other 2 cases it was accompanied by other cardiac lesions including hypertrophy, pericarditis and endocarditis. The other causes found were interauricular communication (n = 1) and pericarditis (n = 2). Sudden cardiovascular death is a major global public health problem. The lack of epidemiological data on sudden death in Africa motivated our work, which led us to note that 75.3% of all sudden deaths in adults were of cardiovascular origin.

关键词： Sudden Cardiac Death Forensic Medicine Autopsy

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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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A Cross-Sectional Survey on Non-Communicable Diseases and Risk Factors in the Senegalese Army

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Health 2016年第14期8卷 1529-1541页

作者： Abdoul Aziz Ndiaye Alioune Badara Tall Boubacar Gueye Ibrahima Soce Fall sidy Mouhamed Seck Amady Barro Mbodj Ndeye Fatou Ngom-Gueye Awa Gaye Anta Tal-dia Community Health Department University Alioune Diop of Bambey Bambey City Senegal Army Health Service Camp Dial Diop Dakar Senegal WHO Bamako Mali Faculty of Health Sciences Gaston Berger University Saint-Louis Senegal Public Health Department Cheikh Anta Diop University Dakar Senegal

Background: The non-communicable diseases (NCDs) have become a public health priority. The objectives of this study were to measure the prevalence and to assess the risk factors of NCDs among the Senegalese military population to initiate an intervention program. Methods: A cross-sectional survey was conducted in 2014. Two-level stratification was used to sample participants. Data were collected following the protocol recommended by the World Health Organization. Data were managed using Epi-Info 6 software and analyzed using R software. Results: A total of 1224 participants were recruited, of whom 96.9% were men. Their ages ranged from 25 to 60 years with a mean of 39.7 ± 9.2 years. Of participants, 17.2% were active smokers. Average duration of active smoking was 19.9 ± 9 years. The prevalence of current alcohol consumption was 11.5%, with an average of 4 ± 2.7 glasses a day. 97.17% of participants consumed fewer than 5 servings of fruits and vegetables a day. 18.63% had insufficient physical activity. The overall prevalence of high blood pressure was 26.9%. The proportion of those who were overweight was 27.2%;3.3% were obese. 3.0% of participants had diabetes and 44.1% had hypercholesterolemia. After adjusting for waist circumference, the risk of high cholesterol was 2.42 in the 35 - 44 age group and 2.86 in the 45 - 60 age group in comparison with the 25 - 34 age group. 32% were classified as having stage 2 chronic kidney. Conclusions: The findings of this study indicate the importance of risk factors for NCDs in the Senegalese military population. Intervention based on prevention and health promotion is needed.

关键词： Risk Factors NCDs Military

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HBsAg seroprevalence among Senegalese militaries

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Journal of Medical Colleges of PLA(China) 2014年第4期29卷 203-207页

作者： Abdoul Aziz Ndiaye Ibrahima Socé Fall Gora Lo sidy Mouhamed Seck Alioune Badara Tall Boubacar Gueye Amady Barro Mbodj Anta Tal-dia Community Health Department University Alioune Diop of Bambey Army Health Service Camp Dial Diop DakarSenegal WHO Mali Faculty of Health Sciences Gaston Berger University Public Health Department Cheikh Anta Diop University

Background: Chronic hepatitis is a major public health problem. The hepatitis B virus is the primary cause, and Hepatitis B and C together are responsible for 60% of cirrhosis and 80% of hepatocellular carcinomas. This study measured the prevalence of HBsAg among Senegalese military to develop a strategy to prevent cirrhosis and hepatocellular carcinoma in the ***: We conducted a descriptive cross-sectional study among Senegalese army staff aged 25 to 60 years and divided this group into three strata: 25-34, 35-44 and 45-60 years. A sample of 1224 participants was selected following a two-level stratification. The mark of surface HBs antigen(Ag) was performed on 1195 participants using chemiluminescence(qualitative Architect HBsAg of Abbott diagnostics Laboratories Germany) and enzyme immunoassay(Determines HBsAg) methods. The presence of HBsAg was analyzed according to age, marital status, alcohol consumption and glomerular filtration rate. Epi-info6 and R software were used, respectively, for data capture and analyses. A Chi-square test was performed to compare proportions considering an alpha significance level of 5% and a confidence interval of 95%.Results: The average age was 39.8±9.2 years. Participants in the age groups of 25-34 years, 45-60 years and 35-44 years were 30.7%, 34.4% and 34.9% of the sample, respectively. Married persons accounted for 82.6% of participants, and 17.08% were single. Most participants were educated(99%), and 56% had reached at least the secondary school level. Alcohol consumption was at 11.5%. The HBsAg prevalence rate was 10.8% [9.1% to 12.7%] with a significant difference between age groups(P<0.001), which ranged from 5.6% for 45-60 years, 9.62% in the 25-34 years group and 16.9% for the 35-44 years group. Marital status and alcohol consumption did not affect the carriage of HBsAg. The prevalence of HBsAg was more common among participants who had a glomerular filtration rate greater than 90 ml/min. Transaminases rate ex

关键词： Seroprevalence HBsAg Military Chronic diseases

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Idiopathic Adult Nephrotic Syndrome: A Clinicopathological Study and Response to Steroid in a Sub-Saharan African Country

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Open Journal of Nephrology 2016年第2期6卷 61-65页

作者： Maria Faye Ahmed Tall Lemrabott Mouhamadou Moustapha Cisse Jean De Dieu Nzambaza Cherif Mouhamed dia sidy Mohamed Seck Khodia Fall Moustapha Faye Elhadji Fary Ka Abdou Niang Boucar Diouf Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Anatomo-Pathology Laboratory Grand-Yoff General Hospital Dakar Senegal Faculty of Medicine Gaston Berger University Saint-Louis Senegal

Introduction: Idiopathic nephrotic syndrome represents 25% to 30% of glomerulonephritis in adults. These glomerulonephritides are responsible of about the half of chronic kidney failure examined as well in United States as in Europe or Africa. The aim of this study was to determine the anatomoclinic, therapeutic and progression patterns of idiopathic nephritic syndrome in Dakar. Patients and Methods: It is a retrospective ten-year study in the nephrology department of Aristide Le Dantec Hospital. Patients with idiopathic nephrotic syndrome were included. We analyzed anatomoclinic, therapeutic and progression data of idiopathic nephrotic syndrome. Results: On 202 patients with nephrotic syndrome, 156 (77%) were primitive. The mean age was 29.7 ± 12 years with a sex ratio of 2.4. Edema was found in 98 patients (62.8%) and hypertension in 63 patients (40%). The mean proteinuria was 6.8 ± 4.8 g/24h. Histologic lesions found at renal biopsy were focal segmental glomerulosclerosis in 71 patients (45.5%), minimal change disease in 68 patients (43.5%) and membranous nephropathy in 8 patients (5%). 134 patients (85.8%) received steroids alone, 12 patients (7.6%) received cyclophosphamide and 4 patients (2.5%) azathioprine in association with steroids. 44 patients (28.2%) reached remission. The factors of poor prognosis were: age, above 40 years, proteinuria above 10 g/24h, existence of renal failure at admission, absence of use of steroids therapy. Conclusion: This study shows that idiopathic nephrotic syndrome is frequent in our country with a prevalence of 77%. The most common lesion found at the renal biopsy is the focal segmental glomerulosclerosis. Remission is found only in 28% which is very low. 33% of patients progress towards chronic kidney disease due to the lack of early diagnosis and the use of traditional medicine.

关键词： Idiopathic Nephrotic Syndrome Focal Segmental Glomerulosclerosis Minimal Change Disease Membranous Glomerulonephritis

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Secondary Hypertension in Sub-Saharan African Populations: A Retrospective Study between 2011 and 2016 at Regional Hospital of Saint-Louis, Senegal

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Open Journal of Nephrology 2016年第3期6卷 93-97页

作者： Yaya Kane Joel Simon Manga diatou Gueye dia Maiga Moussa Zeinabou Tondi Ahmed Tall Lemrabott Maria Faye sidy Mouhamed Seck Mouhamadou Moustapha Cisse Alex Ismael Keita Kalilou diallo El Hadj Fary Ka Abdou Niang Boucar Diouf Nephrology-Cardiology and Internal Medicine Department Assane Seck University Ziguinchor Sénégal Nephrology and Internal Medicine Department Gaston Berger University Saint-Louis Sénégal Nephrology Department Abdou Moumouni University Niamey Niger Nephrology Department Teaching Hospital Aristide Le Dantec Dakar Senegal

Introduction: High blood pressure (HBP) is a worldwide health issue responsible of high cardiovascular morbidity and mortality. Even though essential HBP is far the most frequently reported in patients, secondary causes must be known because of their severity and the possibility of aetiological treatment. No recent epidemiological data are available about secondary causes of HBP in black African populations. The aim of this study was to describe aetiological patterns of secondary HBP in patients followed at Saint-Louis Hospital. Patients and Method: We conducted a retrospective and descriptive study in regional hospital of Saint-Louis. All patients aged ≥15 years old admitted from January 1st 2011 to January 31st 2015 in internal medicine, nephrology, emergency and cardiology departments were included. Clinical, paraclinical data and patients outcomes were collected from medical records. Hypertension was defined according to JNC8 criteria. Secondary HBP was considered if explorations identified a clear aetiology to hypertension. Statistical analysis was done with Excel 2010 and STATA 12.0. Results: We included 9253 patients with mean age of 35 ± 12 years (15 - 83 years) and sex-ratio of 1.6. Overall 67.5% of patients had hypertension and secondary causes were found in 10.5% of them. The majority of patients presented clinical symptoms suggesting a secondary cause of HBP and first-line laboratory explorations were normal in half of cases. Renal diseases were responsible for 79.1% of secondary HBP cases mainly dominated by glomerulonephritis (22.6%), vascular nephropathies (18.7%) and autosomal dominant polycystic kidney disease (5.8%). They were followed by preeclampsia (13.6%) and endocrinal aetiologies such as hyperthyroidism (5.8%), hypercorticism (0.5%), pheochromcytoma (0.5%), primary hyperparathyroidism (0.4%) and Conn’s adenoma (0.1%). Combination of ≥3 antihypertensive drugs was necessary in 71.5% of cases and surgical treatment was performed in three patient

关键词： Secondary High Blood Pressure Internal Medicine Black Africans

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Acute Coronary Syndromes in Semi-Urban African Areas: Clinical Aspects and Management in Ziguinchor (Senegal)

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Open Journal of Emergency Medicine 2021年第4期9卷 179-187页

作者： Simon Joël Manga Mame diarra Mbaye sidy Lamine Sy Quinta Te Indafa Cardiology Departement Hospital de la Paix Assane Seck University of Ziguinchor Ziguinchor Senegal Cardiologie Departement Fann National University Center Dakar Cheikh Anta Diop University Ziguinchor Senegal

Context and Objectives: Acute coronary syndromes (ACS) constitute a major medical emergency. In Senegal, outside the capital Dakar, there is a lack of appropriate care structures. The objective of this work was to study the ACS treatment in the city of Ziguinchor. Methodology: This was a retrospective study of acute coronary syndromes’ cases admitted to the two-level two hospitals in the city of Ziguinchor from January 1, 2016 to December 31, 2019. We included all patients with acute angina pain at rest and/or electrocardiographic changes in at least two contiguous leads. The data were analysed using sphinx V5 software. Results: 57 cases were collected. The average age was 60.1 ± 14.1 years. There was a male predominance with a sex ratio of 3.7. The majority of patients arrived at the hospital by unsafe delivery (70.5%). Symptomatology was dominated by typical angina pain (50.8%). On the electrocardiogram, a majority of acute coronary syndromes with ST segment shift were observed (70.2%). Doppler echocardiography found abnormalities in segmental kinetics in 69.8% of cases. The troponin dosage was performed in 7 patients, i.e. 12.3%. The average time of treatment was 3.4 ± 4.5 days. Medical treatment remained standard and no patient was thrombosed. The average hospitalization period was 5 ± 3.2 days. The hospital lethality was 7.2%. Conclusion: Acute coronary syndromes constitute a medical emergency. dia

关键词： Acute Coronary Syndromes Clinic Management Ziguinchor

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