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Scleroderma in Guinea’s African: Epidemiological, Clinical and Therapeutic Aspects

Open Journal of Internal Medicine 2018年第4期8卷 248-254页

作者： Amadou Kaké Djibril Sylla boh fanta diané Thierno Amadou Wann Alpha Amadou Sank Diallo Mohamed Maciré Soumah Thierno Mamadou Tounkara Moussa Keita Mohamed Cissé Internal Medicine Department Donka National Hospital/University Gamal Abdel Nasser of Conakry Conakry Guinea Dermatology Venerology Department Donka National Hospital/University Gamal Abdel Nasser of Conakry Conakry Guinea

Introduction: Scleroderma is a generalized condition of the connective tissue, arterioles and micro-vessels characterized by tissue fibrosis, vascular obliteration and abnormal humoral and cellular immune responses. The aim of this study was to describe the epidemiological, clinical, therapeutic and evolutionary aspects of scleroderma at the Department of Dermatology-Venerology at Donka National Hospital. Methods: This was a descriptive cross-sectional study with a retrospective collection of data for a period of 11 years, from January 1, 2000, to December 31, 2010, covering all inpatient records of Scleroderma in the service. Results: We collected 17 cases of scleroderma out of 3289, a frequency of 0.04%. The average age of patients was 33.33 years with extremes of 10 and 60 years. A female predominance was noted with a sex ratio M/F of 0.13. Cutaneous induration was the main symptom associated with the phenomenon of Raynaud, and disorders of pigmentation. The extra-skin manifestations were mainly dominated by gastrointestinal involvement (32%), pulmonary involvement (24%), cardiac (20%), articular (20%) and renal (12%) involvement. The systemic form was the most common (99.45%). Corticotherapy was the most prescribed treatment (24.59%). Clinical improvement was noted in (93.2%) of the cases. Conclusion: Scleroderma, although rare, deserves special attention at all levels for early diagnosis.

关键词： Scleroderma Epidemiology Clinical Evolution Guinea

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Lyell Syndrome with Fatal Outcome in Two Pregnant Women Receiving Antiretroviral Therapy in Guinea Conakry

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Journal of Cosmetics, Dermatological Sciences and Applications 2013年第2期3卷 135-138页

作者： Mohamed Cissé Mohamed Maciré Soumah Thierno Mamadou Tounkara boh fanta diané Fodé Bangaly Sack Houleymatou Baldé Amara Camara Aissata Dabo Camara Alhousseini Doumbouya Dermatology-STD Donka Teaching Hospital Gamal Abdel Nasser University of Conakry Conakry Guinea Infectious and Tropi- cal Diseases Donka Teaching Hospital Gamal Abdel Nasser University of Conakry Conakry Guinea

An old woman, 28 years old, weighing 74 kg was referred for skin detachment associated with bubbles and mucosal erosions. This clinical picture had occurred 15 days after the institution of a triple combination: AZT (300 mg) + 3TC (150 mg) and nevirapine (200 mg), during a pregnancy of 20-week gestation. The woman was in her third gestation. The second case is aged 26, weighing 65 kg. This clinical picture had occurred 20 days after the administration of a triple therapy combination: AZT (300 mg) + 3TC (150 mg) and nevirapine (200 mg), during a pregnancy of 32-week gestation. It was the fourth gestation. The birth of a stillborn had occurred the day before his admission into our service. The diagnosis of Toxic Epidermal Necrolysis with nevirapine was selected on the basis of the clinical and anamnestic arguments. The biological tests showed the following results: transaminases (ALT and AST) were within normal limits, blood glucose, and urea > 10 mmol/l. The evolution was marked by the patient death to Day 9 (D9) and at D2 of hospitalization. Discussion: NET and the SJS have been reported in pregnant women as potentially dangerous complications that are often associated with suspected drugs. Among these drugs, antiretroviral drugs, prescribed to pregnant women to prevent mother to child transmission of HIV are often reported. Our case is an illustration of the problem of HIV management in pregnant women. It also focuses on the association between pregnancy and Toxic Epidermal Necrolysis. Nevirapine is an effective drug in the regimens proposed in the management of HIV patients in limited resources countries. But the high frequency of toxidermia with this drug should lead to its replacement by other antiretrovirals least providers of toxidermia as anti proteases in the context of PMTCT programs.

关键词： Lyell Pregnant Women Nevirapine Fatal Outcome

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Severe Drug Eruption in Guinea Conakry

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Journal of Cosmetics, Dermatological Sciences and Applications 2014年第5期4卷 339-343页

作者： Mohamed Cissé Thierno Mamadou Tounkara boh fanta diané Mohamed Maciré Soumah Moussa Keita Fodé Bangaly Sako Fodé Amara Traoré Houleymatou Baldé Aissata Dabo Camara Alhousseine Doumbouya Amara Camara Dermatology STD Donka Hospital Gamal Abdel Nasser University of Conakry Conakry Guinea Infectious and Tropical Diseases Donka Hospital Gamal Abdel Nasser University of Conakry Conakry Guinea

Severe drug reactions are defined as mucocutaneous complications secondary to systemic administration of drugs likely to be life threatening. Our work was designed to determine the evolutionary epidemiological and etiological characteristics of severe drug reactions to the Department of Dermatology Venereology, at Donka Teaching Hospital. A prospective descriptive study of all cases of severe drug reactions received at the Department of Dermatology Venereology of the Donka Teaching Hospital was conducted over a period of two years, from June 2009 to May 31, 2011. We identified 22 Stevens-Johnson syndrome, 13 Toxic Epidermal Necrolysis, 1 Stevens-Johnson syndrome Border Toxic Epidermal Necrolysis, 1 Drug Rash with Eosinophilia and Systemic Symptoms and 2 Acute generalized exanthematous pustulosis among 481 hospitalized patients, of whom 50 had consulted for drug reactions, that is to say, a frequence of 10.40%. The Stevens-Johnson syndrome accounted for 44%, the Stevens-Johnson syndrome Border Toxic Epidermal Necrolysis 2%, Toxic Epidermal Necrolysis 26%, Drug Rash with Eosinophilia and Systemic Symptoms 2% and Acute generalized exanthematous pustulosis 4% of drug reaction. The female sex was predominant (28 women vs. 11 men), that is to say 71.59% vs. 26.21 with a sex ratio of 2.55. The average age of our patients was 29.72 years;the range of ages 21 - 40 years was the most affected (51.28%) followed by 0 - 20 years (33.33%). The lethality rate was 9.09% (2/22) in the Stevens-Johnson syndrome and 53.85% (7/13) in the Toxic Epidermal Necrolysis. HIV infection was found in 17.95% (7/26) of our patients and 71.42% (5/7) of the deceased. The drug accountability was established in 79.48%;the most commonly implicated drugs in the Toxic Epidermal Necrolysis were sulfonamides followed by ARVs (nevirapine) and anti TB (isoniazid);in the SJS sulfonamides followed by salts of quinine and anti TB, the only case of DRESS was due to quinine. No drug was found in 20.52% (8 cases).

关键词： Severe Drug Eruption

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微后坐自动武器的迁移式自动机虚拟样机研究

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计算机仿真 2014年第1期31卷 26-30页

作者：袁点王刚中北大学机电工程学院山西太原030051

针对为在某新型微后坐自动武器的样枪研制,研究发射过程中枪械的迁移式自动机支柱建模的问题,因自动武器发射时火药燃烧、高压抽壳以及整枪发射时各机构间的多体接触比较复杂,建立起该自动武器的虚拟样机模型有一定难度。采用对迁移式... 详细信息

针对为在某新型微后坐自动武器的样枪研制,研究发射过程中枪械的迁移式自动机支柱建模的问题,因自动武器发射时火药燃烧、高压抽壳以及整枪发射时各机构间的多体接触比较复杂,建立起该自动武器的虚拟样机模型有一定难度。采用对迁移式自动工作原理进行分析,对膛底合力与抽壳力进行理论研究;采用建模软件UG、计算软件matlab和机械系统动力学自动分析软件ADAMS多平台进行结合,最终在ADAMS中建立起迁移式自动机的虚拟样机模型。根据多体动力学理论,仿真得到自动机运动曲线,结果证明建立起迁移式自动的虚拟样机是可行的,仿真获得的自动机运动参数为某微后坐武器研制和实验提供了技术支持。

关键词：迁移式自动机微后坐抽壳力虚拟样机

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