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Prevalence of Renal Failure in Children and the Need for Dialysis in Paediatric Nephrology in a Developing Country

Open Journal of Nephrology 2022年第1期12卷 101-111页

作者： Younoussa Keita Aliou A. Ndongo Fatou Ly Ndeye C. cisse Liliane N. D. M. Yamba Babacar Niang Djiby Seck amadou Sow Ndeye F. Sow Abou Ba Indou D. Ly Aliou Thiongane amadou L. Fall Idrissa D. Ba Modou Gueye Pape M. Faye Assane Sylla Pediatric Unit of Aristide Le Dantec Hospital Dakar Senegal Pediatric Unit of Pikine Hospital Dakar Senegal Pediatric Unit of Albert Royer Hospital Dakar Senegal Pediatric Unit of Abass Ndao Hospital Dakar Senegal Pediatric Unit of Dalal Diam Hospital Dakar Senegal

Background: Renal failure is among the major visceral failures responsible for morbidity and mortality in children. Epidemiological data on renal failure in children are limited in sub-Saharan Africa, including Senegal. We conducted this study to assess the prevalence of renal failure (RF) and the need for dialysis in the paediatric nephrology unit. Patients and methods: This was a retrospective and descriptive study in the pediatric nephrology unit from 1st January 2020 to 30 June 2021, including children with acute or chronic RF. The need for dialysis was judged to be met by its effectiveness in face of an indication. The data collected were analysed on sphinx plus 2017 software. Results: The prevalence of RF was 60% (n/N = 132/220). RF was acute in 59% (n/N = 78/132) of cases. The mean age was 6.53 ± 4.77 years with a sex ratio of 1.8. The mean serum creatinine level was 27.22 mg/L (240.9 μmol/L) and BUN at 0.85 g/L. The aetiologies were dominated by prerenal AKI (Acute Kidney Injury) complicating nephrotic syndrome (NS) in 37.2% (n/N = 29/78) and dehydration due to stomach flu in 17.6% (n/N = 9/51). Acute post-infectious glomerulonephritis including group A streptococcus and plasmodium falciparum accounted for 16.7% (n = 13/78) of intrinsic AKI. The need for dialysis was unmet in 50% (n/N = 7/14) with a mortality of 14.1% (n/N = 11/78). The mean age of the patients with chronic RF was 8.68 ± 4.74 years with a sex ratio of 2.6. The mean serum creatinine level was 36.56 mg/L (323.5 μmol/L) and the BUN level was 0.99 g/L. Half of the children were classified as having CKD stage II (early stage). The aetiologies were dominated by primary focal and segmental glomerulosclerosis (FSGS), 53.7% (n/N = 29/54), renal hypoplasia, 22.2% (n/N = 12/54) and reflux nephropathy, 29.4% (n/N = 5/17). The need for dialysis was unmet in 46.1% (n/N = 6/13). The overall mortality of chronic kidney disease (CKD) with RF was 29.6% (n/N = 8/27). Conclusion: The prevalence of RF was high i

关键词： Renal Failure Glomerulonephritis Hypodysplasia Dialysis Children

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Association between Uric Acid and Metabolic Syndrome in Homozygous Sickle Cell Patients

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Advances in Biological Chemistry 2021年第3期11卷 142-148页

作者： Kandji Pape Matar Djite Moustapha Barry Nene Oumou Kesso Sagne Rene Ngor Thioune Ndeye Mareme Mbacke Ndoumbé Mame Ndour El Hadji Malick Gueye-Tall Fatou Lopez-Sall Philomene cisse Aynina Diop Pape amadou Gueye Papa Madieye Laboratory of Biochemistry-Hematology National University Hospital of Fann Dakar Senegal Laboratory of Pharmaceutical Biochemistry Faculty of Medicine Pharmacy Cheikh Anta Diop University Dakar Senegal

The objective of this study was to assess the association between uric acid and the metabolic syndrome and its components in homozygous sickle cell patients. This is a prospective case/control study of sickle cell SS patients. Each patient was matched to a control of the same sex and age ± 2 years. In our framework, we used the criteria for defining metabolic syndrome according to International Diabetes Federation (IDF) 2009. Assay of all biological parameters was performed with the ARCHITECT ci4100, Abbot (Chicago, Illinois, USA). Data were collected with Excel 2016 software and statistical analysis was done using XLSTAT 2019 software. Student’s T test was used to compare means and a p-

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Chest Trauma at the Emergency Department of the Gabriel TouréUniversity Hospital Bamako, Mali

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Open Journal of Emergency Medicine 2021年第2期9卷 18-24页

作者： Almeimoune Abdoulhamidou Diop Madane Thierno Mangane Moustapha Démbele Seidou Alaji Coulibaly Mahamadoun Sogoba Youssouf Abdoulaye Chiad Mahamadoun cisse Harouna Sangare Sidy Yattara Ogalat Enyengue Murielle Ingrid Kassogue André Diallo Boubacar amadou Bah Madiassa Konaté Yoro B. Sidibe Diango Djibo Mahamane Department of Anesthesia Resuscitation and Emergency Medicine at CHU Gabriel Toure Bamako Mali Bamako Faculty of Medicine and Odontostomatology Bamako Mali Resuscitation Anesthesia Service CHU IOTA Bamako Mali Anesthesia and Intensive Care Unit CHU Luxembourg Bamako Mali Neurosurgery Department The Gabriel Touré University Hospital Bamako Mali Emergency Department The Hospital of Mali Bamako Mali Department of Anesthesia Resuscitation and Emergency Medicine at CHU Point G Bamako Mali General Surgery Department The University Hospital of Gabriel Toure Bamako Mali

In Mali, chest injuries remain a real public health problem and are associated with heavy morbidity and mortality. Faced with a resurgence of urban civil violence and the explosion of road accidents, we decided to conduct this study in order to describe the epidemiological, clinical and therapeutic aspects of thoracic trauma in the emergency department. Method and Material: This is a descriptive prospective study over a period of one year in the emergency department of the CHU Gabriel Touré. Including all patients admitted for thoracic trauma. Analysis and Entry: Data were entered and analyzed on SPSS software version 20.0. The test was significant for a p value Results: We recorded 21,090 appeals in our structure among which 1284 patients were suspected of thoracic trauma. The diagnosis of thoracic trauma was retained in 119 (0.56%) patients. All patients were transported to the emergency room without prehospital medicalization. Clinical presentation was dominated by dyspnea in 54.6% of patients, however pain was the almost constant symptom in conscious victims. Various traumatic mechanisms had caused these lesions of the thorax, of which road traffic accidents represented half of the causes, followed by urban civil violence in 28.6% of patients. Landslides and falls from a great height were responsible for 19.5% of chest injuries. Open chest trauma was the type of lesion found in a third of the cases. This type of injury was exclusively due to blows and injuries during the brawls. Standard chest radiography was performed as the first intention in 60% of patients compared to 10.9% for the pleuropulmonary ultrasound. Thirteen patients required ventilatory assistance after orotracheal intubation. The average length of stay was 65.23 hours. During the period of our study, the overall mortality was 1.85% in the emergency departments with a lethality specific to chest trauma of

关键词： Chest Trauma Emergencies Bamako Mali

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Haemorrhagic Lupus: A Diagnosis Emergency, Report about 6 Cases

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Open Journal of Internal Medicine 2021年第4期11卷 231-237页

作者： Fall Biram Codou Walah Dimitri Dieng Mouhamed Diaw Bamba Tode Johanita Gaye Ahmadou Salane Aly Ndao Awa Cheikh cisse amadou Fall Sow Maimouna M. A. Ndour Djiba Boundia Kane Baidy Sy Fall Seynabou Leye Abdoulaye Pouye Abdoulaye Ndongo Souhaibou Department of Internal Medicine at DalalJamm Hospital Dakar Sénégal Department of Internal Medicine at Dantec Hospital Dakar Sénégal Department of Internal Medicine at Pikine Hospital Dakar Sénégal Department of Hematology at DalalJamm Hospital Dakar Sénégal

Introduction: Haemorrhagic manifestations rarely represent the mode of onset of lupus and are a therapeutical and diagnosis emergency. We report 6 cases of haemorrhagic manifestations disclosing lupus. Patients and methods: It’s about a retrospective, descriptive and multicentric study ranged from 1st January 2014 to 5th January 2019. Were included in the study all cases of lupic disease revealed by hemorrhagic disorders, recorded in 3 Internal Medicine Departments in Dakar: DalalJamm, Dantec, Pikine. The diagnosis of lupus was made on the basis of the 1997 modified classification criteria of ACR for SLE. Results: We gathered 6 cases of women affected by lupic disease. The mean age was 32 years old with extremes ranged from 17 to 56 years. According to haemorrhagic disorders, the diagnosis of lupus was automatically made in 5 of the cases and it took 6 months to confirm the last one. Haemorrhagic features were ruled by purpura (3/6 cases) and nose-bleeding associated with gumbleeding (2/6 cases), epistaxis and melena (1/6 case), hypermenorrhea (1/6 case), cerebral haematoma (1/6case). Cutaneous (5/6), articular (4/6), renal (2/6) and serous (2/6) disorders specially represented the other manifestations. Biological findings showed cytopenia with 3 cases of anaemia, 1 case of leucopenia and 6 cases of thrombopenia. The average of the platelet count was at 20,000 cells/mm3 with extremes ranged from 1000 to 35,000 cells/mm3. Thrombocytopenia was related to autoimmune thrombocytopenic purpura in 3 cases, to Evans’ syndrome in 2 cases, to macrophage activation syndrome in 1 case. Immunological investigations found the presence of antinuclear antibodies (1/6), anti-dsDNA (2/6) and anti-Sm (4/6). All patients received a bolus of Solumedrol followed by an administration of Prednisone at a dosage of 1.5 mg/kg (3 cases) and 1 mg/kg to the other patients. A transfusion of platelet concentrates was performed for all of them. The evolution was favorable in 4 cases. Two

关键词： Haemorrhagic Lupus Emergency

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Hemoglobinopathy and Systemic Lupus: A Rare Association

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Open Journal of Internal Medicine 2019年第3期9卷 72-77页

作者： Assétou Kaya Soukho Ibrahima amadou Dembele Djenebou Traore Nounga Romuald Nyanke Djibril Sy Abasse Sanogo Mamadou Cissoko Barry Boubacar Sangare Mamadou Malle Sékou Mamadou cisse Abdramane Traore Mahamadou Saliou Nanko Doumbia Brehima Boly Berthe Kaly Keita Boubacar Zoumana cisse Drissa Sangare Youssouf Fofana Kokou Tbah Tighankpa Adramé Keita Mamadou Keita Mamadou Dembele Abdel Kader Traore Hamar Alassane Traore Department of Internal Medicine Point G University Teaching Hospital Bamako Mali

The authors report a case of systemic lupus associated with a composite heterozygosis SC with thalassemic component in a 19-year-old patient hospitalized for anemia and polyarthralgia who has a staturoponderal delay, macular erythematous lesions in butterfly wings on the face and ears, photosensitivity, puffy face, alopecia, pubic and axillary hair loss, scalp dermatophytosis, painful swelling of the interphalangeal joints, wrists and knees. The hemoglobin electrophoresis showed a compound heterozygote SC associated with β thalassemia. Antinuclear antibodies were positive with an anti-Sm positive antibody. Conclusion: The diagnosis of both diseases can be difficult when symptoms are concomitant and look alike.

关键词： Hemoglobinopathy Lupus University Teaching Hospital Point G

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Evaluation of Kidney Function in Patients with COVID-19 at the Epidemiological Treatment Centre in CHNU Fann

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Advances in Biological Chemistry 2023年第1期13卷 17-24页

作者： Thioune Ndeye Mareme Kandji Pape Matar Djite Moustapha Barry Nene Oumou Kesso Zaamoumi Bassma Kane Mame Coumba Diagne Bineta Mbacke Mame Ndoumbé Sagne René Ngor Ndour El Hadji Malick Gueye-Tall Fatou Lopez-Sall Philomene cisse Aynina Diop Pape amadou Gueye Papa Madieye Laboratory of Biochemistry-Hematology National University Hospital of Fann Dakar Senegal Laboratory of Pharmaceutical Biochemistry Faculty of Medicine Pharmacy Cheikh Anta Diop University Dakar Senegal

Alteration of renal function during SARS-CoV-2 infection is frequent and is associated with excess mortality. It is multifactorial, involving mechanisms more specific to COVID-19: viral invasion, endothelitis and thrombosis, activation of the renin-angiotensin-aldosterone system, and elevation of pro-inflammatory cytokines. Thus, the objective of this work was to assess renal function in patients with moderate and severe forms of COVID-19. This was a prospective cross-sectional study of patients with COVID-19. The parameters studied were age, sex, uremia, creatinine and glomerular filtration rate (GFR). All biological parameters were measured with the A15 Biosystems automated system (Barcelona, Spain) and the GFR was calculated according to the MDRD formula. Data processing was carried out with the SPSS (Statistical Package for Social Sciences) software version 23. Our study population consisted of 192 subjects with COVID-19, of which 111 were moderate and 81 were severe. The mean age of our subjects was 60 years and a sex ratio of 1.02. GFR assessment showed that 28% of the population had a lowered GFR (2). Analysis of the results according to the clinical forms showed frequencies of 19% of disturbance of renal function for the moderate forms against 40% for the severe forms. Impaired renal function appears to be frequent in patients with severe SARS-CoV-2 infection and is associated with a bad prognosis. Any patient hospitalized with SARS-CoV-2 should benefit from an initial nephrological assessment which could be used as a marker to dictate the prognosis of the severity of COVID-19.

关键词： COVID-19 CTE GFR Renal Function SARS-CoV-2

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Diabetic Foot: Epidemiological, Therapeutic and Evolutionary Aspects in the Department of Medicine and Endocrinology of the Hospital in Mali, Mali

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Journal of Diabetes Mellitus 2022年第1期12卷 18-27页

作者： Nanko Doumbia Adama Alexis Diarra Seydou Mariko Drissa Sangare Danfaga Bakary Nouhoum Ouologuem Samaké Magara Sekou Mamadou cisse Mamady Coulibaly Mahamadou Saliou Bakary Dembele Yacouba L. Diallo amadou Kone Modibo Mariko Bah Traore Massama Konate Djenebou Traore Djeneba Sylla Kaya Assetou Soucko Assa Traore Department of Medicine of the Mali Hospital Bamako Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Kati Reference Center Kati Mali Gynaecology Department of the Mali Hospital Bamako Mali Department of Medicine and Medical Specialty of the Fousseyni Daou Hospital Kayes Mali Nephrology Unit of the Fousseyni DAOU Hospital Kayes Mali Health and Social Affairs Department of the National Police Bamako Mali Internal Medicine Department of the Gabriel Toure University Hospital Bamako Mali Faculty of Medicine Bamako Mali Internal Medicine Service of the Point G University Hospital Bamako Mali

Introduction: The diabetic foot remains a public health problem due to its high frequency, difficult and costly management. The aim of this study was to determine the epidemiological, therapeutic and evolutionary aspects of the diabetic foot in a hospital setting in Bamako. Methodology: This is a retrospective, descriptive, cross-sectional and monocentric study conducted between September 1, 2011 and December 31, 2015 on diabetic patients aged 14 years and older arriving in our department with a foot infection. Results: We identified 94 cases of diabetic foot infection out of a total of 828 hospitalized patients, a prevalence of 11.35%. The age range 41 - 60 years represented 57 cases (60.6%), the extreme ages were 14 and 81 years. Men (38.3%), women (61.7%) with a sex ratio of 0.62%. Housewives 50%, illiterate 51 cases (54.3%), low economic standard of living 40 cases (42.6%), presence of osteitis 40 cases (42.6%), foot at stage D Grade3 28 cases (29.8%). Management was medical in 48 cases (51.1%), treatment with insulin 58 cases (61.7%), Amoxicillin + Metronidazole used 36 cases (38.29%). Amputation was performed in 35 cases (37.2%). Deaths concerned 5 patients (9.6%) with hypoglycemia as the main cause in 4 cases. Conclusion: Diabetic foot is a frequent complication of diabetes. The establishment of a multidisciplinary team should contribute to the improvement of the prognosis of the diabetic foot in a management center.

关键词： Diabetic Foot Epidemiology Therapeutics Evolution Mali Hospital

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Diabetic Foot: Epidemiological and Clinical Aspects in the Department of Medicine and Endocrinology of the Hospital of Mali, Mali

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Journal of Diabetes Mellitus 2021年第4期11卷 159-170页

作者： Nanko Doumbia Danfaga Bakary Nouhoum Ouologuem Drissa Sangare Adams Alexis Diarra Magara Samaké Sekou Mamadou cisse Mamady Coulibaly Mahamadou Saliou Bakary Dembele Yacouba L. Diallo amadou Kone Modibo Mariko Bah Traore Massama Konate Djenebou Traore Djeneba Sylla Kaya Assetou Soucko Assa Traore Department of Medicine of the Mali Hospital Bamako Mali National Center for Scientific and Technological Research (CNRST) Bamako Mali Kati Reference Center Kati Mali Department of Medicine and Medical Specialty of the Fousseyni Daou Hospital Kayes Mali Nephrology Unit of the Fousseyni DAOU Hospital in Kayes Kayes Mali Health and Social Affairs Department of the National Police Bamako Mali Internal Medicine Department of the CHU du Point G Bamako Mali Faculty of Medicine of Bamako Mali

Introduction: Diabetes is a heterogeneous group of metabolic diseases characterized by chronic hyperglycemia resulting from a defect in the secretion and/or action of insulin, diagnosed by the observation of high levels of glucose in the blood, responsible in the long term for vascular and nervous complications. The diabetic foot is the set of pathological manifestations affecting the foot in relation to the diabetic disease. Approximately 5% of diabetics present a chronic lesion of the foot. Objective: To describe the epidemiological and clinical aspects of the diabetic foot in the medicine/endocrinology department of the Mali hospital. Methodology: This was a retrospective descriptive study from November 2011 to December 2015. It focused on diabetic patients hospitalized in the department with a foot wound and aged 14 years and over. Results: The study involved 94 patients out of 828 hospitalized, a prevalence of 11.35%. Our series included 36 (38.3%) men and 58 (61.7%) women, i.e. a sex ratio of 0.61%. The mean age was 42.66 years with extremes of 14 and 81 years. Type 2 diabetes was present in 95% of the patients with a duration of evolution of more than 5 years in 60.6% of the cases. The mechanism of occurrence of the wounds was minor trauma in 54 cases (57.4%). Self-medication was the primary treatment in 70 patients (74.5%). More than 50% of the patients wore unsuitable footwear. Clinical and para-clinical examinations revealed isolated neuropathy in 37 cases (39.4%), necrotic wound in 37 cases (39.19%), poor glycemic control: HbA1c > 7% (98.9%), absence of osteitis (57.4%), normal Doppler ultrasound 45 cases (45.7%), stenosing arteriopathy 11 cases (22.3%), non-stenosing 3 cases (20.2%), germs present 56 cases (59.6%) including 21 cases (22.4%) of Staphylococcus aureus. Conclusion: Diabetes and diabetic foot constitute a real public health problem. They are responsible for

关键词： Diabetic Foot Epidemiology Clinic Bamako

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Risk Factors for COVID-19 Related Death during the First Three Waves of the Pandemic in an Epidemic Treatment Center at Dakar, Senegal

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Advances in Infectious Diseases 2023年第2期13卷 117-131页

作者： Moustapha Diop Papa Samba Ba Viviane Marie Pierre cisse Ndèye Aissatou Lakhe Betty Fall Moustapha Lo Ndong Essomba Bruce Wembulua Fatimata Wone Becaye Fall Khardiata Diallo-Mbaye Daye Ka Louise Fortes Ousmane Faye Ndongo Dia Khalifa Ababacar Wade Abdou Rajack Ndiaye amadou Alpha Sall Moussa Seydi Mame Thierno Dieng Epidemic Treatment Center Dakar Principal Hospital Dakar Senegal Infectious and Tropical Diseases Department FANN Teaching Hospital Dakar Senegal Psychiatry Department Dakar Principal Hospital Dakar Senegal Internal Medicine Department Deido District Hospital Douala Cameroon Dalal Jamm Hospital Dakar Senegal Federation of Laboratories Dakar Principal Hospital Dakar Senegal Pasteur Institute of Dakar Dakar Senegal Anesthesia-Resuscitation Department Dakar Principal Hospital Dakar Senegal Dakar Principal Hospital Dakar Senegal

Introduction-Objective: COVID-19 is a highly transmissible but often mild viral infection. However, some patients can present severe COVID-19 and subsequently die. The aim of the present study was to assess the risk factors for COVID-19 related death during the first three waves of the disease at the Epidemic Treatment Center (ETC) of Dakar Principal Hospital (DPH). Method: We conducted a descriptive and analytical perspective survival study from April 4, 2020 to September 25, 2021, including adult patients with COVID-19, hospitalized at the ETC of DPH. Log Rank test and multivariate Cox model were performed to identify risk factors for death. Results: We included 556 COVID-19 patients with mean age of 57 ± 17 years and a male-to-female ratio of 1.26. The number of deaths during one month of follow-up was 41, representing a cumulative risk of 7.4%. The log Rank test showed that being from the third wave (p = 0.0056), advanced age (p = 0.00098), presence of at least one comorbidity (p = 0.034), High blood pressure (p = 0.024), d-dimer level ≥ 1000 IU/L (p Conclusion: Our study showed that elderly and third-wave of COVID-19 patients were more at risk to die. Knowledge of risk factors for COVID-19 related death could improve the prognosis of these patients.

关键词： COVID-19 Waves Death Risk Factors Dakar

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