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Profile of Extra-Pulmonary Tuberculosis in Internal Medicine

Open Journal of Internal Medicine 2024年第1期14卷 64-73页

作者： Mouhamed Dieng Djiby Sow Demba Diédhiou Michel Assane ndour Boundia Djiba Mouhamed Almahy Niang matar Ndiaye Oumar Boun Khattab Diouf Fatou Kiné Gadji Anna Sar maïmouna ndour mbaye Clinique Médicale II H&ocircpital Aristide Abass Ndao Université Cheikh Anta Diop Dakar Sénégal

Introduction: Tuberculosis is an infectious disease that mainly affects the lung. Extrapulmonary localizations are a reason for hospitalization in our health facilities. The objective of this study was to describe the epidemiological, clinical, paraclinical and evolutionary aspects of extra pulmonary tuberculosis (EPT) at the Abass Ndao Hospital Center. Patients and Methods: This was a descriptive cross-sectional study conducted over a period of 11 years (January 1, 2010 to December 30, 2021). All patients with extrapulmonary tuberculosis hospitalized in the department of internal medicine during the recruitment period were included. Results: Fifty-two (52) patients were collected. The year 2019 recorded the most cases 23.08% (n = 20). The mean age of the patients was 40.56 ± 18.24 years. The age group 20 - 34 years 42.31% (n = 22) was the most represented. Females were in the majority 61.54% (n = 32) with a sex ratio (M/F) was 0.63. Housewives were in the majority 40.38% (n = 21). 60.87% of the cases (n = 14) came from a health facility. 38.46% of the cases had been infected. 21.74% (n = 9) were smokers. The reasons for consultation were dominated by fever (67.44%), AEG (62.79%) and cough (41.86%). Eighteen patients (40.91%) had fever. The mean time to consultation was 77.37 ± 90.3 days with extremes of 3 and 365 days. The median was 45 days. More than half of the patients 61.90% (n = 26) had anemia. Positive retroviral serology was noted in 21.43% of cases. All patients had a CRP greater than 6. More than half of the patients 51.92% (n = 27) had multifocal tuberculosis. The peritoneum 44.23% (n = 23) was the main organ affected. The average hospital stay was 9.8 ± 4.9 days with extremes of 1 and 19 days. All patients had received the protocol in force at the national level. Death was noted in 4 patients (9.52%). Conclusion: EPT is characterized in our context by a notorious diagnostic difficulty due to the multiplicity of clinical presentations, the complexity of

关键词： Extrapulmonary Tuberculosis Epidemiology Diagnosis Senegal

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Profile of Autoimmune Polyendocrinopathies at the Medical Clinic II of the Abass Ndao Hospital: About 40 Cases

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Open Journal of Internal Medicine 2024年第1期14卷 74-82页

作者： Michel Assane ndour Djiby Sow Mouhamed Dieng Ibrahima mané Diallo Boundia Djiba Mélaine Honorine Olympio Julie Borges Preira Muriel Diembou Fatou Kiné Gadji Fama Ndiaye El Hadj mamadou Moussa Thioye Charles Halim Demba Diédhiou Anna Sarr maïmouna ndour mbaye Abass Ndao Hospital Internal Medicine Department Cheikh Anta Diop University Dakar Senegal Aristide Le Dantec Hospital Internal Medicine Department Cheikh Anta Diop University Dakar Senegal

Introduction: Autoimmune polyendocrinopathies (AP) represent a group of rare concomitant pathologies, making them underdiagnosed. The objective was to study their profile at the Medical Clinic II of the Abass Ndao Hospital. Patients and Methods: This was an observational, descriptive and analytical study, lasting 24 months, from January 1, 2020 to December 31, 2022. We assessed the epidemiological, clinical and paraclinical characteristics of the patients and classified the APs found. Results: We included 40 patients divided into type III (38 cases) and IV (2 cases). A female predominance was noted with a sex ratio of 0.21. The mean age was 38.6 years. A family history of component diseases of autoimmune polyendocrine syndrome (APS) was found in 62.5%. Goiter (80%) was the main clinical sign present. All 38 patients with ISAP-3 had autoimmune thyroiditis, including 29 cases of Graves’ disease (72.5%) and 9 cases of Hashimoto’s thyroiditis (22.5%). They were associated with either type 1 diabetes (57.9%), Biermer’s disease (21.1%), vitiligo + alopecia (18.4%), lupus (2.6%). The 2 patients with AP-4 had Biermer’s disease associated with either Addison’s disease or type 1 diabetes. management depended on the pathologies present and their possible complications. The immunological phenomena were also controlled. Conclusion: This series is globally similar to the literature. The polymorphous character of the clinical pictures requires a better collaboration between specialists leading to a clinical and holistic synthesis.

关键词： APS Biermer Graves’ Disease Hashimoto’s Addison’s Vitiligo Senegal

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Three Cases of Plasma Cell Leukemia

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Open Journal of Internal Medicine 2022年第3期12卷 137-144页

作者： Mouhamed Dieng Atoumane Faye Jules Dabi Gabnon Baïdy Sy Kane maïmouna Sow Michel Assane ndour Seynabou Fall Nafi Diagne Awa Cheikh Ndao Demba Diedhiou Boundia Djiba Fatou Samba Ndiaye maïmouna ndour mbaye Anna Sarr Awa Oumar Touré Abdoulaye Pouye Division of Internal Medicine Aristide Le Dantec Hospital Dakar Senegal Division of Internal Medicine Abass Ndao Hospital Dakar Senegal Division of Clinical Hematology Dalal Jamm Hospital Dakar Senegal Division of Biological Hematology Aristide Le Dantec Hospital Dakar Senegal

Introduction: Plasma cell leukemia (PL) is a rare lymphoproliferative disorder characterized by the monoclonal proliferation of plasma cells in the marrow and blood peripheral. It is defined by a blood plasmacytosis greater than 2 G/l or a plasma cell level greater than 20% of leukocytes. It can be primitive or secondary to multiple myeloma (MM). We reported 3 cases of PL. Observations: Case 1: A 59 years old woman with fever, anemia with 7 g/dl, hyperleukocytosis 9200/mm3, thrombopenia 86 G/l inflammatory biological syndrome with CRP at 129 mg/l, hypercalcemia at 120 mg/l, renal failure with serum creatinine at 35 mg/l, urea at 0.85 g/l and 24-hour proteinuria at 0.98 g/24h. Β2 microglobulin at 10.34 mg/l. The blood smear shows dysmorphic plasma cells at 68% and the bone marrow at 79% of dysmorphic plasma cells. The immunophenotyping of blood cells, the electrophoretic serum protein, shows PL CD38+, secondary of a MM LAMBDA. Case 2: A 65-year-old man with type 2 diabetes presented, right femoral neck, anemia, hyperleukocytosis at 22 G/l, and thrombocytopenia at 99 G/l. There was no hypercalcemia, or kidney failure. The blood smear showed 28% of plasma cells and 9% of blasts. On the myelogram, the marrow was normal richness with significant medullary plasmacytosis (31%) made up of dysmorphic plasma cells. The CT scan showed a settling of the body of D5 with heterogeneous osteocondensation. The patient was transferred to hematology where she was treated with polychemotherapy. The evolution was unfavorable following a death due to malignant hypercalcemia. Case 3: A 62-year-old woman who had a 5-year follow-up of Ig G kappa multiple myeloma was treated with Melphalan, Prednisone, and thalidomide with a therapeutic break for 2 months. She came back to the Internal Medicine department with: severe global dehydration, anemia with externalized bleeding gingivorrhagia, pain in mechanical bones of the ribs, lower limbs, and pelvis, bilateral pneumonia. The biology

关键词： Plasma Cell Leukemia Multiple Myeloma

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Assessment of Insulin Therapy in 281 Children and Adolescents with Type 1 Diabetes in Senegal

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Open Journal of Pediatrics 2022年第1期12卷 283-292页

作者： Djibril Boiro Amadou Sow Aliou Abdoulaye Ndongo Idrissa Basse Lamine Thiam Ndiogou Seck Cheha Fatoumia Babacar Niang Modou Guéye maïmouna ndour mbaye Ousmane Ndiaye Abass Ndao Hospital Dakar Senegal Aristide Le Dantec Hospital Dakar Senegal Diamniadio Children’s Hospital Dakar Senegal Ziguinchor Peace Hospital Dakar Senegal Saint Louis Regional Hospital Dakar Senegal Albert Royer Children’s Hospital Dakar Senegal

Introduction: In Senegal, with the CDIC “Changing Diabetes In children” project, insulin has been made free. The objective of this study was to evaluate the accessibility and modalities of insulin therapy in the management of type 1 diabetes. Methodology: This was a retrospective study including patients followed for type 1 diabetes (T1DM) in hospital between April 2018 and December 2020. Results: 281 patients were included. The mean age was 14.22 years. The mean age at diagnosis was 11.28 years. Ketoacidosis was the main mode of discovery of diabetes at 51.6%. Premix and rapid insulins were most commonly used at 84.7% and 82.9% respectively, most often in combination. The most commonly used treatment regimen was three injections/day in 82.5% of cases. The average daily insulin dose was 0.62 IU/Kg/dr. Of the patients, 219 (78%) were self-monitoring of blood glucose. The average number of blood glucose checks was 1.78 per day. 76 patients (27%) went days without an insulin injection and up to 7 days in 51% of cases. The main reasons were forgetfulness, therapeutic errors and stock-outs. Hypoglycaemia was observed in 14.2%. The average glycated haemoglobin was 10%. Conclusion: Despite the efforts made, there are still challenges to improve access to insulin. The reinforcement of therapeutic education on insulin therapy is essential for a better quality of life of diabetic children and adolescents.

关键词： Diabetes Children Insulin Therapy Senegal

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Association between Hyperhomocysteinemia and Microangiopathic Complications (Neuropathy and Nephropathy) in Subjects with Type 1 and Type 2 Diabetes

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Journal of Diabetes Mellitus 2023年第4期13卷 325-339页

作者： Nene Oumou Kesso Barry Soukeyna Gueye Moustapha Djité Pape matar Kandji Michel Assane ndour El Hadj malick ndour Demba Diedhiou Fatou Gueye-Tall Ndeye mareme Thioune Najah Fatou Coly Dominique Doupa maïmouna ndour mbaye Philomène Lopez Sall Papa madieye Gueye Laboratory of Pharmaceutical Biochemistry University Cheikh Anta DIOP Dakar Senegal Laboratory of Biochemistry University Hospital Fann Dakar Senegal Department of Internal Medicine Abass Ndao Hospital Center Dakar Senegal Medical Biology Laboratory Diamniadio Children Hospital Dakar Senegal Department of Medical Biochemistry Saint-Louis University Saint-Louis Senegal

This prospective case-control study aimed to assess the prevalence of hyperhomocysteinemia and explore its potential correlation with microangiopathic complications, specifically nephropathy and neuropathy, in a cohort of both type 1 and type 2 diabetic patients. Conducted at the marc Sankalé Center of Abass Ndao Hospital in Dakar from June to September 2018, the study enrolled a total of 106 diabetic patients, comprising 93 type 2 diabetics and 13 type 1 diabetics, who were matched with control subjects free from clinically detectable pathologies, based on sex and age ± 2 years. The mean age of type 1 and type 2 diabetic patients was 24.46 ± 8.41 years and 57.28 ± 11.28 years, respectively. Our findings revealed a statistically significant elevation in mean homocysteine levels among patients when compared to controls (12.63 vs. 9.88;p male, and 42% were female. The analysis of neuropathy and nephropathy frequencies among type 2 diabetic patients, stratified by homocysteine concentrations, demonstrated a notably higher prevalence of diabetic nephropathy in patients with hyperhomocysteinemia compared to those with normohomocysteinemia (23.07% vs. 8.75%;p = 0.052). Similarly, diabetic neuropathy exhibited a significantly greater frequency in patients with hyperhomocysteinemia as opposed to normohomocysteinemia (80.76% vs. 50%;p = 0.005). Furthermore, our results established a significant positive correlation between homocysteine concentrations and both age (r = 0.402;p < 0.0001) and creatinine levels (r = 0.461;p < 0.0001). Bivariate logistic regression analysis indicated that patients with hyperhomocysteinemia faced 3 times and 6 times higher risks of developing neuropathy (OR = 3.5;p = 0.061) and diabetic nephropathy (OR = 6.092;p = 0.014), respectively.

关键词： Homocysteine Hyperhomocysteinemia Diabetes Mellitus Type 1 Diabetes Type 2 Diabetes Nephropathy Neuropathy

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Profile of Female Hyperandrogenism at the Medical Clinic II: About 19 Cases

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Open Journal of Endocrine and Metabolic Diseases 2023年第5期13卷 63-74页

作者： Michel Assane ndour Demba Diédhiou Djiby Sow Ibrahima mané Diallo Mouhamed Dieng Fatou Gueye Astou Mbodj Julie Borges Preira Fatou Kiné Gadji Muriel Diembou Fama Ndiaye El Hadj Mouhamadou Moustapha Thioye Charles Halim Anna Sarr maïmouna ndour mbaye Internal Medicine Department Abass Ndao Hospital Cheikh Anta Diop University of Dakar Dakar Senegal

Introduction: Female hyperandrogenism is essentially manifested by hirsutism. It is present in Senegal but not yet elucidated for lack of data. This is why we proposed to study the profile of hyperandrogenism in our context. Patients and Methods: This was an observational, cross-sectional cohort study of 19 patients of reproductive age followed for hyperandrogenism at the Medical Clinic II of Abass Ndao Hospital, from November 1st, 2019 to August 31st, 2021. Results: Our cohort consisted of women with an average age of 25.3 years, single (73.7%), with a low socioeconomic level (42.1%). A family history of hirsutism was found in 31.6% of cases. The main reasons for consultation were a menstrual cycle disorder in 94.7% of cases, and hirsutism in 78.9% of cases. The latter was post-pubertal (66.7%), with a slow or progressive evolution. The physical examination revealed: hirsutism (100%) with an average modified Ferriman Gallwey score (mFG) of 8.9 ± 5.8, acne (36.8%), hyperseborrhea (57.9%), major signs of virilization (10.5%), acanthosis nigricans (47.4%) and galactorrhea (5.3%). Hormonal explorations revealed an elevation of: testosterone (31.6%), 17-hydroxyprogesterone (5.3%), dihydrotestosterone (31.6%), and prolactin (10.5%). The ovarian morphology was micropolycystic (84.2%). The etiological profile corresponded to polycystic ovarian syndrome or PCOS (68.4%), ovarian hyperthecosis (10.5%), hyperprolactinemia (10.5%), congenital adrenal hyperplasia or CAH (5.3%). Idiopathic hirsutism was found in 5.3% of cases. Conclusion: Female hyperandrogenism is a less frequent reason for consultation in endocrinology. It deserves to be further evaluated in a large-scale study focused on epidemiological, clinico-biological and etiological investigation, in order to assess its prevalence and better define its profile in our context.

关键词： Female Hyperandrogenism Hirsutism Senegal

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Prolactin Adenomas in Senegal: Epidemiological, Diagnostic and Therapeutic Aspects of 89 Cases

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Open Journal of Internal Medicine 2023年第3期13卷 209-217页

作者： Michel Assane ndour Demba Diédhiou Djiby Sow Boundia Djiba Mouhamed Dieng Ibrahima mané Diallo Fatou Kiné Gadji Julie Borges Muriel Diembou Fama Mody Ndiaye El Hadj Mouhamadou Moustapha Thioye Charles Halim Philippe Moreira Anna Sarr maïmouna ndour mbaye Medical Clinic II Abass Ndao Hospital Center Cheikh Anta Diop University Dakar Senegal

Introduction: In Senegal, there is very little data on prolactinomas despite their negative impact on couples fertility. Patients and methods: This was a multicentre, retrospective, descriptive, analytical study conducted from 1 January 2008 to 31 December 2022 in the neurosurgery departments of the Fann and Principal hospitals and the endocrinology department of the Abass Ndao Hospital. Results: We included 89 patients, representing a prevalence of 36.7% among all cases of pituitary adenoma. The mean age was 35.6 ± 10 years and the sex ratio was 0.34. The mean time to consultation was 27.1 ± 29 months. Clinical symptoms were dominated by gonadotropic disorders represented by galactorrhoea (71 cases, 79.8%), amenorrhoea (61 cases, 68.5%), and infertility in the couple (31 cases, 34.8%). Fifty-seven (58) patients presented with a tumour syndrome (65.2%, including 57 cases of headache (64%), 34 cases of visual disorders (38.2%) and 8 patients with a dysmorphic syndrome (8.9%). Imaging revealed a macroadenoma in 68.5% (61 cases) and extension of the adenoma in 11 patients (12.4%). The hormonal profile was isolated lactotropic hypersecretion (80 cases, 89.9%) and mixed in 9 cases (including concomitant secretion of GH in 8 cases and ACTH in 1 case). All patients had initially benefited? from dopaminergic agonist-based medical treatment. Pituitary surgery was effective in 45 patients (50.6%), including 44 cases by transsphenoidal approach. Postoperative incidents included transient diabetes insipidus (77.7%) and cerebrospinal fluid leakage (20%). We noted 7 cases (7.9%) of death presenting with a tumour syndrome (100%), a macro-adenoma (85.7%), having undergone pituitary surgery (42.9%). The factors significantly associated with prolactinoma were young age (p Conclusion: This series also demonstrates the impact of prolactin adenomas on reproductive function. Delayed diagnosis explains the predominance of macroadenomas, which are a source of pre- and post-operative compli

关键词： Prolactinoma Fertility Disorders Tumour Syndrome Pituitary Adenomas

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Primary Hyperparathyroidia at the Abass Ndao Hospital Center: About 29 Cases

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Open Journal of Internal Medicine 2023年第4期13卷 427-435页

作者： Demba Diédhiou Michel Assane ndour Mouhamed Dieng Charles Halim Ibrahima mané Diallo Djiby Sow Fatou Kiné Gadji Ndeye Déthié Beye Fama Mody Ndiaye El Hadj M. M. Thioye Boundia Djiba Boucar Ndong Awa Cheikh Ndao Anna Sarr maïmouna ndour mbaye Service de Médecine Interne Centre Hospitalier Abass Ndao Université Cheikh Anta Diop Dakar Sénégal Service de Médecine Nucléaire et de Biophysique Faculté de Médecine Pharmacie et d’Odontologie Université Cheikh Anta Diop Dakar Sénégal Service de Médecine Interne Centre Hospitalier Aristide Le Dantec Université Cheikh Anta Diop Dakar Sénégal

Introduction: In Senegal, there is very little data on primary hyperparathyroidism despite an overall upward epidemiological trend. The objective was to describe its epidemiological, clinical, therapeutic and evolutionary aspects. materials and Methods: This was a cross-sectional, descriptive study, conducted over 5 years (from January 01, 2018 to December 31, 2022) at the National Abass Ndao Hospital Center and including all confirmed cases of primary hyperparathyroidism. Results: Twenty-nine patients were included with a female predominance (86.20%) and an average age of 48.10 ± 18.93 years. The discovery of hyperparathyroidism was fortuitous in 79.31% of cases. The main clinical manifestations were osteoarticular (62%) and urinary (34.5%). On average, serum calcium measured was 109.2 ± 7.92 mg/l, corrected serum calcium 111.3 ± 6.25 mg/l, urinary calcium 421.9 ± 96.45 mg/24h and parathormone at 145 ± 159.71 pg/ml. Among the patients, 25 had hypercalcemia (86.2%) and all had 24-hour hypercalciuria. The diagnosis was retained in view of the elevated parathyroid hormone (PTH) values in all patients. Cervical ultrasound objectified a parathyroid adenoma in 27.58% of cases and 12 patients or 46.2% had presented a scintigraphy in favor of a parathyroid adenoma. We found 01 cases of multiple endocrine neoplasia type 2. Bone densitometry performed in 10 patients found osteoporosis in 60% of cases (6 patients) and osteopenia in 40% of cases (4 patients). Surgical treatment was performed in 12 patients (41.4%). The histology of the surgical specimens was in favor of a parathyroid adenoma in all cases. Among the operated patients, the evolution was marked by a cure rate of 100%. Conclusion: The symptomatology of primary hyperparathyroidism remains mainly osteoarticular and urinary. Surgery has proven its effectiveness in our series. We insist on the systematic dosage of calcemia especially in women over 50 years and the promotion of morphological explorations.

关键词： Primary Hyperparathyroidism Hypercalcemia Parathormone Osteoporosis Dakar

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Case Report: Rhupus (The Association of Systemic Lupus Erythematosus and Rheumatoid Arthritis): About 2 Cases

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第2期14卷 84-88页

作者： Omar Boun Khatab Diouf Mouhamed Dieng Michel Assane ndour matar Ndiaye Nousradine Mourno Tarsa Boundia Djiba Ibrahima mané Diallo Demba Diedhiou Anna Sarr maimouna ndour mbaye Internal Medicine Departement Abass Ndao Hospital Dakar Senegal

Introduction: The association of systemic lupus erythematosus and rheumatoid arthritis (rhupus) is a rare clinical condition. Throughout the world, 287 cases of Rhupus have been described. We report two new observations of two patients who presented predominantly distal erosive polyarthritis with positive anti-Sm antibodies in one case and SmRNP in the other case. Observations: Case 1: 37 years old patient, with a recent diagnosis of pulmonary tuberculosis. She has since 8 months an inflammatory, bilaterally and symmetrical polyarthralgia without deformation or ankylosing synovitis, associated with malar erythema without other abnormalities. Immunological tests showed: positive Rheumatoid factor at 158 IU/ml, positive Anti-CCP at 550 IU/ml, and positivity of antinuclear at 1/1280 nuclear fluorescence with a strong presence of anti-Sm >8 IU/ml. The diagnosis of rhupus was concluded, without serious visceral involvement. Case 2: A 28-year-old patient, married with 3 children, with bilateral, symmetrical, deforming and chronic polyarthritis affecting large and small joints, which had been evolving for over 5 years without cutaneous abnormality associated. Paraclinical investigations showed: a biological inflammatory syndrome. Immunology was positive, with rheumatoid factors at 78 IU/ml, anti-CCP at 561 IU/ml, antinuclear antibodies at 1/1280 with positive anti-SmRNP and anti-SSA/Ro52, and a positive direct Coombs test. Joint ultrasound revealed tenosynovitis of the extensors and common flexors of the fingers, erosions and synovitis of multiple PPIs. The diagnosis of rhupus was based on the presence of 10 ACR criteria for RA and 8 ACR/EULAR 2019 criteria for SLE. Conclusion: Rheumatoid arthritis is a rare autoimmune disease combining features of both systemic lupus erythematosus and rheumatoid arthritis in the same patient, often sequentially. Despite a growing number of case reports and series, a consensus on the classification of SLE arthritis is still lacking, and di

关键词： Rhumatoïd Arthritis Lupus Rhupus Connective Tissue Disease

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Diabetic macroangioapathy at the Internal Medicine Department of the Abass Ndao Hospital Center (About 359 Cases)

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Journal of Diabetes Mellitus 2024年第1期14卷 1-12页

作者： Sow Djiby Djiba Boundia ndour Michel Assane Diedhiou Demba Dieng Mouhamed Diallo Ibrahima mané Fall Ndiouga Gueye Khoudia Gadji Fatou Kiné Sarr Anna Diop Said Nourou ndour mbaye maimouna Department of Internal Medicine and Medical Specialties H&#244pital Abass Ndao Dakar Senegal

Introduction: macroangiopathy plays an important role, with a high prevalence of morbidity and mortality in diabetic patients. The aim was to study the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of macroangiopathy in diabetic patients in the internal medicine department of the Abass Ndao hospital. Patients and methods: This was a descriptive and analytical cross-sectional study. Our investigations were recruited over a 7-year period (January 1, 2016 to December 31, 2022). Results: Three hundred and fifty-nine (359) patients (10.22%) were enrolled. The mean age was 62.83 years, with extremes ranging from 17 to 98 years. The [60 - 69] age group was more representative (37.32%). Women accounted for 180 cases (50.1%), with a sex ratio (m/f) of 0.99. The average duration of diabetes was 11.86 years. Average consultation time was 38.07 days, with extremes ranging from 1 to 368 days. Average hospital stay was 7.65 days. Inaugural diabetes was noted in 12 cases (3.34%). Type 2 diabetes accounted for 95.82% (n = 344) of patients. Hypertension was present in 150 patients (41.8%). Patients with 2 risk factors accounted for 173 cases (48.18%). Nineteen patients had already had a stroke (5.29% of cases). Fourteen (14) patients (4.2%) were amputees. Obliterative arteriopathy of the lower limbs (AOMI) was noted in 193 patients (54%). Stroke was noted in 101 patients (28%). Ischemic heart disease (IHD) was noted in 38 patients (11%). AOMI was more common in males (110 patients, 57%) than in females (43%). Seventy-three (73) patients (20.3%) died. Predictors of death were age over 60 and the existence of more than two cardiovascular risk factors. Conclusion: Diabetic macroangiopathy is a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.

关键词： macroangiopathy Diabetes Risk Factors Senegal

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