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Cyclophosphamide, Thalidomide and Dexamethasone (CTD) as First-Line Therapy in Multiple Myeloma Patients: An Experience in a Clinical Haematology Centre in Dakar, Senegal

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Open Journal of Blood Diseases 2023年第1期13卷 43-50页

作者： el hadji daouda niang Seynabou Fall Khadim Sarr Marième Lolita Camara Aminata Dakono Awa Ndiaye Modou Moustapha Ciss Amy Thiam Serge Mwamba Fatou Samba Diago Ndiaye Department of Clinical Hematology Dalal Jamm Hospital Dakar Senegal

Introduction: Induction therapy followed by high-dose chemotherapy with autologous stem cell transplantation remains the gold standard for myeloma patients who can tolerate this treatment approach. In a developing country setting, in the absence of availability of bone marrow transplantation, the CTD protocol is an accessible treatment regimen whose efficacy and lower toxicity compared to the Melphalan Prednisone protocol has been reported. This protocol has been administered since 2018 in first line. It’s against this backdrop we perform this study to assess the efficacy of this CTD protocol in first line therapy. Methods: We conducted a descriptive and analytical study including clinical, paraclinical and evolutionary data of 50 patients with MM treated during the period range from 01 September 2018 and 01 July 2022 with the CTD protocol of cyclophosphamide (500 mg at D1, D8 and D15), dexamethasone (40 mg weekly) and thalidomide (100 mg/day) in 28-day cycles. Survival outcomes were estimated by the Kaplan-Meier method. Results: The mean age was 62.3 ± 9.1 years and the sex ratio was 0.7. An advanced prognostic score at diagnosis was found in 73.5% of patients according to the Salmon and Durie score and in 32% according to the ISS. Overall remission was noted in 64%, of which 34% were in very good partial remission and partial remission in 12% of cases. Progression was noted in 4 patients. Treatment-related side effects were mainly peripheral neuropathy and anaemia in 3 patients respectively. The median survival was 38.4 months. The progression-free survival was 60%. An advanced age (≥65 years) is correlated with negative impact on survival (p = 0.04). Conclusion: Cyclophosphamide, thalidomide and dexamethasone give good outcome with less toxicity. Thus, it remains a first-line treatment alternative for newly diagnosed and low-income patients.

关键词： Myeloma Chemotherapy Survival

Compressive Myeloradiculopathies in Multiple Myeloma: Clinical and Radiological Characteristics of a Series of 29 Patients

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Open Journal of Blood Diseases 2021年第4期11卷 133-139页

作者： el hadji daouda niang Mbodji Ahmadou Bamba Ka Mamadou Fall Seynabou Seck Moussa Mbaye Khalifa Ababacar Bousso elimane Sarr Khadim Faye Atoumane Ndiaye Fatou Samba Diago Ndiaye Moustapha Diop Saliou Department of Haematology Cheikh Anta Diop University Dakar Senegal Department of Neurology Cheikh Anta Diop University Dakar Senegal Internal Medicine Service Aristide Le Dantec Hospital Cheikh Anta Diop University Dakar Senegal

Introduction: Patients with multiple myeloma (MM) develop neurological complications such as root and/or spinal cord compression in at least 5% of cases. The aim of this work is to describe the clinical and radiological features of root and/or spinal cord compression occurring during multiple myeloma. Patients and Methods: We conducted a retrospective study in the Clinical Haematology Department of Dalal Jamm Hospital and the National Blood Transfusion Centre, the Neurological Clinic of Fann Hospital Centre and the Internal Medicine Department of Aristide Le Dantec Hospital in Dakar between January 2016 and December 2019. All patients whose multiple myeloma diagnosis was established according to the International Myeloma Working Group’s 2014 and who had root, spinal or myeloradicular compression, were included in our study. Results: A total of 29 patients were included. The average age was 54.31 years [32 - 76 years]. The sex ratio (M/F) was 1.6. Motor deficits were the reason for consultation in 68% of the patients and spinal pains were reported by 93% of the patients. Neurological signs revealed multiple myeloma in all our patients. 25 patients (86.2%) had paraplegia and 1 patient had tetraparesis. Hypoesthesia to a defined sensory level was noted in 8 patients (28%). 5 patients (17.24%) had sphincter disorders. The types of lesions showed by imaging were vertebral lysis in 100% of cases, vertebral compression in 37% of cases, and epidural infiltration in 34% of cases. 12 patients (41.37%) had spinal compression, 14 patients (48.27%) had

关键词： Multiple Myeloma Spinal Cord Compression Root Compression Bone Lesions

Infection in Multiple Myeloma: Microbiological Profile and Prognosis in Senegalese Patients

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Open Journal of Blood Diseases 2024年第2期14卷 47-58页

作者： Seynabou Fall el Hadj daouda niang Khadim Sarr Lolita Mariéme Camara-Tall Modou Moustapha Ciss Amy Thiam Aminata Dakono Awa Ndiaye Fatou Samba Diago Ndiaye Clinical Hematology Department of Dalal Jamm Hospital Gudiawaye Dakar Sngal Hematology Clinic Unit of Aristide Le Dantec Hospital Dakar Sngal

Introduction: Infections are additional factors of morbidity and mortality in multiple myeloma (MM), and the current recommendation is antibiotic prophylaxis. In sub-Saharan Africa, few data on infectious complications of MM are available. We aim to describe the microbiological features of infections in MM, and their impact on survival in Senegalese patients. Methods: A retrospective (January 2005-January 2022), analytic, multicenter study on infections in patients followed for MM (IMWG criteria) in Senegalese clinical hematology services. The socio-epidemiological, diagnostic, microbiological, evolutionary and survival aspects were analyzed. Results: The study included 106 patients with multiple myeloma who had an infection at admission or during the treatment. Ten patients have the comorbidity (hypertension, lupus, type 2 diabetes). These patients had 136 infectious events identified at diagnosis (79.2%) or during chemotherapy (20.8%). The sites of infection are lung (42.6%), urinary (29.4%), dermatological (6.6%), digestive (5.2%), osteoarticular (4.4%), ear, nose and throat (3.7%), central nervous system (1.5%), or without site. We recorded 26.4% of patients with multi-site infections. The causal pathogens are bacteria (Gram-negative bacilli: 22.1%;Gram positive bacilli: 9.5%, Mycobacterium tuberculosis: 13.3%), parasitique (plasmodium falciparum 6.6%), viruses (SARS-COV2: 2.9%, VZV: 2.2%) and fungal (2.9%). Survival was reduced in patients who had an infection at the time of multiple myeloma diagnosis (p: 0.189) and those who had multiple infectious foci (p: 0.011). Conclusion: Infections in multiple myeloma are more frequent at diagnosis. The germs are varied and mostly bacteria, particularly gram-negative bacteria, and Kochs bacillus. Our study reveals that multiple infectious foci are a poor prognosis factor. It is necessary to evaluate the infectious risk early, and to adopt an antibiotic prophylaxis based on our tropical environment.

关键词： Multiple Myeloma Infections Tuberculosis Senegal

Influence of Topography on the Distribution and Structure of Woody Plants in the Senegalese Sahel (Sandy Ferlo)

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American Journal of Plant Sciences 2024年第1期15卷 14-28页

作者： Moustapha Bassimbe Sagna Aïssatou Ndong Thiam Khoudia niang Oumar Sarr Aly Diallo Sekouna Diatta daouda Ngom Aliou Guissé Department of Plant Biology Faculty of Science and Technology Cheikh Anta Diop University Dakar Senegal IRL 3189 “Environment Health Society” Tessekere Human Environment Observatory (Senegal) Dakar Senegal Department of Agronomy and Plant Production El Hadji Ibrahima Niasse University Kaolack Senegal Department of Agroforestry Assane Seck University Ziguinchor Senegal

This study describes the floristic composition and structure of a woody stand in the Senegalese Sahel, paying particular attention to the edaphic factors of its floristic composition. A stratified inventory considering the different relief units was adopted. Woody vegetation was surveyed using a dendrometric approach. The results obtained show that the flora is dominated by a few species adapted to drought, such as Balanites aegyptiaca (L.) Del., Calotropis procera Ait. and Boscia senegalensis (Pers.). The distribution of this flora and the structure of the ligneous plants are linked to the topography. In the lowlands, the flora is more diversified and the ligneous plants reach their optimum level of development compared with the higher relief areas. In the lowlands, there are a few woody species which, in the past, were indicative of better climatic conditions. These are Anogeissus leiocarpus (DC.), Commiphora africana (A. Rich.), Feretia apodanthera Del., Loeseneriella africana (A. Smith), Mitragyna inermis (Willd.) and Sclerocarya birrea (A. Rich). It is important that their reintroduction into reforestation projects takes account of their edaphic preference.

关键词： Woody Plants Distribution Topography Ferlo Senegal

Physicochemical and Biochemical Characterization, Total Phenolic and Energy Value from Bulbs of Different Onion (Allium cepa L.) Varieties in Senegal

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Food and Nutrition Sciences 2024年第2期15卷 129-139页

作者： Ndeye Adiara Ndiaye Lahat niang Modou Dieng Ndeye Coumba Kane Touré Laboratory of Microbiology Graduate School Polytechnique (ESP)-UCAD Dakar Senegal Water Energy Environment and Industrial Processes Laboratory (LE3PI) Graduate School Polytechnique (ESP)-UCAD Dakar Senegal University Sine Saloum el Hadj Ibrahima Niass (USSEIN) Kaolack Senegal

The purpose of this study is to investigate the physicochemical properties of some local varieties of onion (Allium cepa L.) and compare them with an imported variety, all collected in May 2021. Proteins, reducing sugars, lipids, and polyphenol content were estimated according to the AFNOR standardized methods. The determination of calcium, magnesium, iron, sodium, potassium and phosphorus was performed by atomic absorption spectrophotometer coupled with a CCD detector. The results highlighted an average acidity of 0.377% ± 0.002% lower than the value of the imported variety which is 0.520% ± 0.001%. Local varieties have a pH ranging from 6.35 ± 0.003 to 6.42 ± 0.004, while the variety has a pH of 6.36 ± 0.003. The ash and dry matter contents vary respectively from 4.788% ± 0.004% to 8.253% ± 0.003% and 7.945% ± 0.021% to 11.945% ± 0.007% for the local varieties. Moreover, the imported one has ash and dry matter contents of 5.175% ± 0.007% and 10.035% ± 0.021% respectively. The results show that the protein, reducing sugar and lipid contents in the local onion varieties vary respectively from 2.815 ± 0.000 to 15.634 ± 0.001 g·100 g-1;4.691 ± 0.001 to 12.596 ± 0.002 g·100 g-1 and 0.006 ± 0.001 to 0.050 ± 0.057 g·100 g-1. Furthermore, the imported variety has a protein, reducing sugar and lipid content of 5.649 ± 0.002;8.565 ± 0.002 g·100 g-1 and 0.011 ± 0.010 g·100 g-1 respectively. The maximum levels of total polyphenols are obtained in the imported variety, Bellani and Gandiol, respectively 9.973 ± 0.001, 4.535 ± 0.002, and 3.425 ± 0.006 mg EAG/g of dry matter. The local varieties have a significant calorific intake of between 35.451 ± 0.001 and 112.980 ± 0.003 kcal·100 g-1 compared to the imported one with an energy value of 56.953 ± 0.001 kcal·100 g-1 of dry matter. The bulbs of different onion varieties studied have a fairly high content of mineral elements. The potassium content of loc

关键词： Allium cepa L. Characterization Physicochemical Biochemistry Total Phenolic

Assessment of Some Secondary Metabolites, Minerals and Alcohol Content of Noni Juice Obtained by Fermentation of Morinda citrifolia L. Fruit from Senegal

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American Journal of Plant Sciences 2024年第7期15卷 577-588页

作者： Ndèye Adiara Ndiaye Mame Ndew Mbaye Lahat niang Modou Dieng Nicolas Cyrille Ayessou Ndeye Coumba Kane Touré Laboratory of Microbiology Graduate School Polytechnique (ESP)-UCAD Dakar Senegal Department of Chemical Engineering and Applied Biology Graduate School Polytechnique (ESP)-UCAD Dakar Senegal Water Energy Environment and Industrial Processes Laboratory (LE3PI) Graduate School Polytechnique (ESP)-UCAD Dakar Senegal University Sine Saloum el Hadj Ibrahima Niass (USSEIN) Kaolack Senegal

The fruit of Morinda citrifolia L., commonly known as noni, has an extensive history of use as a food and traditional medicine around the world. Adding value to Morinda citrifolia L. products, particularly the fruit, could be one way of building resilience in vulnerable farming households. The aim of this study was to determine the secondary metabolite and mineral composition of noni juice obtained by fermenting the fruit of Morinda citrifolia L. Fruits were collected in August 2022 from the local field in Thiès region, West of Senegal. Extraction yields were determined and the secondary metabolites were determined using conventional analytical methods. Calcium, magnesium, iron, sodium and potassium were determined by atomic absorption spectrophotometer coupled with a CCD detector. The results show that an average fruit mass (503.2 ± 110.96 g) consists of 171.44 ± 50.01 g pulp and 34.06 ± 10.35 g seeds. The traditional extraction yield of noni juice is 16.46% after three weeks of fermentation. The contents of total polyphenols, flavonoids and tannins obtained in noni are 608.97 ± 4.53 mg EAG/100mL, 7.78 ± 0.01 mg EQ/100mL and 0.191 ± 0.01 mg EC/100mL respectively. The ethanol content of noni varies from 3.57 to 5.23 mL/100mL during extraction. Noni has a high calcium content with a concentration of 383.79 ± 33.23 mg/L. This is followed by a good concentration of magnesium, potassium and sodium, at 278.47 ± 26.30, 187.43 ± 10.7 and 155.95 ± 28.66 mg/L respectively. Noni also has an iron content of 202.15 ± 0.05 mg/L.

关键词： Morinda citrifolia L. Juice Alcohol Total Phenols Flavonoids Tannins Minerals

Lesions Superimposed by Traditional Medicine on Renal Biopsies in Senegal

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Open Journal of Pathology 2023年第4期13卷 224-228页

作者： Cherif Mouhamed Moustapha Dial Toni Djibrilla Gani el hadji Fary Ka Abdou niang Boucar Diouf Pathology Laboratory of the Idrissa Pouye General Hospital Dakar Senegal Reference General Hospital Niamey Niger Nephrology Department of Aristide le Dantec Hospital Dakar Senegal

Traditional African medicine products are responsible for kidney damage that baffles both nephrologists and pathologists. Renal biopsies reveal acute or chronic inflammatory changes that cannot be explained by the progressive stage of the basic lesion of the nephropathy. The aim of this study is to analyze the lesions superimposed on 73 kidney biopsies from patients who took traditional herbal medications to treat the symptoms of kidney disease.

关键词： Nephropathy Traditional Medicine Pharmacopoeia Senegal

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

Pathological Fractures in Chronic Hemodialysis Patients in a Teaching Hospital in Senegal: Prevalence and Associated Risk Factors

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Open Journal of Nephrology 2023年第3期13卷 211-219页

作者： Ahmed Tall Lemrabott Baratou Coundoul Niakhaleen Keita Maria Faye Moustapha Faye Mansour Mbengue Bacary Ba Seynabou Diagne Abdou niang el hadji Fary Ka Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Department of Nephrology Dalal Jamm National Hospital Center Dakar Senegal Dialysis Center National Hospital Center of Pikine Pikine Senegal

Introduction: The lack of follow-up and adequate management of chronic kidney disease-mineral and bone disorder (CKD-MBD) in chronic hemodialysis patients is associated with pathological fractures. Few studies are available on the subject in sub-Saharan Africa. The objective of this work was to evaluate the prevalence of pathological fractures in our chronic hemodialysis patients, to analyze their clinical aspects and to determine the factors associated with their occurrence. Patients and Methods: We conducted a retrospective, descriptive and analytical study over 9 years (January 1, 2011, to December 31, 2020) based on the medical records of chronic hemodialysis patients at the CHU Aristide Le Dantec. The diagnosis of pathological fracture was retained in front of any fracture occurring spontaneously or following minimal trauma and confirmed by X-ray. Results: Nineteen cases of pathological fractures were collected with a hospital prevalence of 19.39%. The mean age was 53.32 ± 13.94 years with a sex ratio of 0.36. The average seniority in dialysis was 84.16 ± 29.88 months. Among these patients, one had had 3 episodes of fractures and another 6 episodes. The circumstances of occurrence of the fractures were the fall in 63% of the cases, spontaneously in 37% of the cases. The predominant site of fractures was the femoral neck (47.38% cases). Female gender (p 5 years (p = 0.049), gait disturbances prior to the fracture (p = 0.001), positive CRP (p = 0.028) and the presence of vascular calcifications (p = 0.002) were significantly associated with the occurrence of pathological fractures. Conclusion: This study has identified the factors associated with the occurrence of pathological invoices in hemodialysis patients in our context. These fractures are often associated with the lack of regular biological follow-up due to the low socioeconomic level of our patients.

关键词： Pathological Fractures CKD-MBD Hyperparathyroidism Osteomalacia Adynamic Bone Disease Chronic Hemodialysis