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Morbi Infectious Mortality of Diabetics Hospitalized at the Medical Clinic of Abass Ndao Health Center

Open Journal of Endocrine and Metabolic Diseases 2018年第1期8卷 1-8页

作者： Djiby Sow Demba Diédhiou Ibrahima mané Diallo Michel Assane ndour mahecor Diouf marie Ka-Cissé Anna Sarr maimouna ndour-mbaye Clinique Médicale II Centre Hospitalier Abass Ndao (UCAD) Dakar Senegal Medical Clinic of Abass Ndao Health Center Cheikh Anta Diop University Dakar Senegal

Introduction: Diabetes is a public health problem and is exposed to some complications, particularly infectious. The work on this entity remains segmentary in Africa. The objective was to describe the morbi infectious mortality of the diabetics at the Medical Clinic II of Abass Ndao Health Center of Dakar. Patients and Methods: This was a cross-sectional, descriptive and analytical study conducted from 01 January 2016 to 31 December 2016. It covered patients with diabetes hospitalized during the study period. Epidemiological data and infectious diseases were evaluated. Results: During the study period, 346 diabetics have respected the inclusion criteria. These were 165 men (47.68%), a sex ratio of 0.91. The mean age was 56.17 years. The age group of [60 - 69 years] accounted for 31.5% and 95.6% of the patients came from the Dakar region. The average age of diabetes was 10.31. Diabetes had been evolving for less than 5 years in 25.15% of patients and inaugural in 11.46%. About 82.36% of our patients had type 2 diabetes. The acute complications of diabetes were ketoacidosis (51.89%), hyperosmolar hyperglycemia (0.58%), and hypoglycemia (1.45%). The mean infections were the skin and soft tissues (54.91%), urogenital infections (16.18%), respiratory infections (14.45%), malaria (3.46), infections of the skin and soft tissues were dominated by the diabetic foot (41.90%). The 125 non-diabetic patients developed 38 infectious pathologies, the main ones being respiratory infections (24.32%), infections of the skin and soft parts (24.32%). HIV infection was observed in 0.28% of diabetics and 8.10% of non-diabetic patients. 93 patients died (15.70%). Fifty-one of them died of infectious diseases (54.8%), 42 non-infectious diseases (45.16%), and subjects aged over 60 years, representing 72.54%. The means of consultation was 30 days. The highest rates of lethality were diabetes (37.41%), acute gastroenteritis (17.64%), and acute pyelonephritis (12.5%). The lethality rates of in

关键词： Morbimortality Diabetes Infection Senegal

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Epidemiological, Clinical and Therapeutic Characteristics of Hypertensive Type 2 Diabetics at the marc Sankale Center of Dakar

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Open Journal of Endocrine and Metabolic Diseases 2018年第2期8卷 59-69页

作者： Djiby Sow Demba Diédhiou Ibrahima mané Diallo Amadou Ndiaye Michel Assane ndour Anna Sarr Said Norou Diop maimouna ndour-mbaye Department of Internal Medicine Ⅱ University Hospital Center of Dakar Cheikh Anta Diop University Dakar Senegal Laboratory Analyzes Medical Biology Abass NDAO Hospital in Dakar Dakar Senegal

Introduction: High blood pressure (hypertension) and diabetes mellitus are two major risk factors for cardiovascular disease, which is increasing rapidly in Africa and worldwide. Africa has the highest prevalence rate of hypertension in the world, with 46% of adults over the age of 25 with. Hypertension is common in type 2 diabetes and increases cardiovascular risk. The association of these two pathologies has many particularities in the sub-Saharan subject. The work related to this entity in Africa shows a frequency between 30% and 60%. The objective was to describe the epidemiological, clinical and therapeutic characteristics at the Medical Clinic II of the Abass Ndao Hospital Center in Dakar. Patients Methods: This was a cross-sectional, descriptive and analytical study conducted from 01 December 2016 to 31 January 2017. It focused on patients with cardiothyrosis. Epidemiological data, cardiovascular risk factors, and cardiothoracic characteristics were evaluated. Results: 303 cases were recorded with a prevalence of 42%, an average age of 61.63 years, a sex ratio of 0.22. The age group of [60 - 70] years was the most representative at 36.30%. The BMI (Body mass Index) average was 27.06 kg/m2. Obesity was 25% and 35% were overweight. Dyslipidemia consisting of an increase in LDL cholesterol > 1 g/l in 79%, a hypercholesterolemia in 57%, a decrease in HDL cholesterol in 13.23% and a hypertriglyceridemia in 28%. Patients with three cardiovascular risk factors accounted for 93.72%. The average fasting glucose level was 2.85 g/l. Hyperglycemia was noted in 65%. The glycosylated hemoglobin is greater than 7% in 47%. The duration of diabetes was less than 5 years in 133 patients or 44%. 70% of patients were treated with oral antidiabetic drugs. Insulin was used in 21.1%. Hypertension was mild in 24.1%, moderate in 23.8% and severe in 14.8%. Hypertension treated with monotherapy was 49%, combination therapy was 43%. Converting enzyme inhibitors (CEI) were used in 44%;20

关键词： Diabetes Hypertension Risk Factors Treatment Senegal

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Evolution of Graves’s Disease: Impact of Socio-Demographic and Clinical Factors in Senegalese Subject

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Open Journal of Internal Medicine 2020年第2期10卷 160-170页

作者： Djiba Boundia Diedhiou Demba Sow Djiby ndour Michel Assane Diallo Ibrahima mané Barrage Ahmed Limane Ka-Cissé mariama Sarr Anna ndour-mbaye maimouna Department of Internal Medicine II University Hospital Center of Dakar Cheikh Anta Diop University Dakar Senegal Department of Internal Medicine I University Hospital Center of Dakar Cheikh Anta Diop University Dakar Senegal

Background: In Graves’s disease, there is a lack of description specific to the gender and age among sub-Saharan African subject. The objective was to evaluate the impact of gender and age on the profile of Graves’ disease in Senegalese subject in order to understand the evolution and improve the therapeutic choices. Methods: This is a retrospective study conducted from January 1, 2010 to December 31, 2017 (07 years) at Abass Ndao University Hospital (Senegal), focused on patients with Graves’ disease followed up under antithyroid drugs treatment for at least 18 months. Results: There were 244 men, 404 subjects between [0 - 25 years], and 101 subjects more than 50 years old. Factors associated with goitre size were male gender (p male gender (p = 0.015), and young age (p male gender (p = 0.049), absence of orbitopathy (p = 0.011), small goiter (p maintenance treatment (p = 0.006). Conclusion: In our Senegalese study, men and young patients are particularized by a trend of voluminous goitre and low rate of remission. These data remain a basis for predicting the outcome of medical treatment and make timely use of radical treatments such as surgery or irratherapy in the presence of risk factors for recurrence.

关键词： Graves’s Disease Profile Gender Age Senegal

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Factors Associated with Death in Subjects Admitted for a Diabetological Emergency: Experience of the Medical Clinic II of the Abass Ndao Hospital Center in Dakar (Senegal) —Death in Diabetic Emergencies

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Open Journal of Endocrine and Metabolic Diseases 2018年第1期8卷 38-48页

作者： Diédhiou Demba Sow Djiby Diallo Ibrahima mané Diallo Abdou Karim ndour Michel Assane Sarr Anna ndour-mbaye maimouna Diop Said Norou Department of Internal Medicine II University Hospital Center of Dakar Cheikh Anta Diop University Dakar Senegal Department of Preventive Medicine and Public Health University Hospital Center of Dakar Cheikh Anta Diop University Dakar Senegal

Introduction: Metabolic and vascular emergencies constitute a risk of lethality in diabetic subjects admitted to hospital. The objective was to evaluate the factors associated with death in subjects admitted for a diabetological emergency to improve management. materials and Methods: It was a 12-month retrospective, descriptive and analytical study at Dakar’s marc Sankale Diabetes Center. The study concerned any type of diabetics subjects admitted for a diabetological emergency. We evaluated the profile of diabetes, the pathologies found and factors associated with death. Results: We identified 697 cases of diabetic emergencies with a prevalence of 13.8%. The sex ratio (M/F) was 0.82, the mean age was 49.6 years, and the mean duration of diabetes was 7.1 years. The metabolic profile was hypoglycemia (11.3%), ketoacidosis (34.6%), and hyperosmolar hyperglycemia syndrome (5%). The associated pathologies were vascular (51.1%), infectious (65.3%), kidney function impairment (7.6%), anaemia (13.8%). During the follow-up, 94 patients died, as an annual frequency of 13.5% among diabetological emergencies. In univariate analysis, the factors significantly associated with death were age > 60 years [OR = 4.09 (2.6 - 6.41)], hyperglycemia [OR = 2.58 (1.50 - 4.4)], hyperosmolar hyperglycemia syndrome [OR = 10.5 (5.19 - 21.5)], septic diabetic foot [OR = 3.57 (2.24 - 5.66)]. Vascular pathologies that significantly associated with death were stroke [OR = 4.06 (2.10 - 7.81)], lower limb arteriopathy [OR = 3.25 (1.84 - 5.73)], cardiovascular collapse [OR = 6.85 (2.34 - 20)]. In addition to diabetes, the deceased patients had one (18%), two (34%) and at least three (45.7%) known factors of poor prognosis. Conclusion: Emergencies in diabetology remain frequent in our practice. The comorbidity (vascular and infectious) constitutes a risk of abnormally high death rate. A particular attention must concern on old diabetics subjects with several pathologies.

关键词： Diabetological Emergencies Mortality Risk Factors Senegal

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Knowledge, Attitudes and Practices (K.A.P) of Pharmacy Pharmacists of the Department of Dakar in the Care of Diabetics

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Journal of Diabetes Mellitus 2019年第3期9卷 113-125页

作者： Diallo Ibrahima mane Diédhiou Demba Sow Djiby ndour Michel Assane Aissatou Camara Ahmet Limane Barrage M. Ka-Cissé Sarr Anna ndour-mbaye maimouna Clinique Médicale II Centre Hospitalier Abass Ndao UCAD Dakar Senegal

Aim: To evaluate the attitude practice and knowledge of pharmacists in the management of diabetes in the department of Dakar. Methodology: Cross-sectional study, conducted from 01 march to 30 September 2017 including all pharmacists in the Dakar region who agreed to participate in the survey. Data was collected through a pre-established questionnaire. Results: A total of 144 pharmacists were included in the study, representing a participation rate of 87.58%. The average age was 33.90 years, with a sex ratio of 1.69. Pharmacists were single in 50.88% of cases, and a minimum experience of 5 years was found in 64.03% of cases. Pharmacist assistants accounted for 57.9% of our study population. The assessment of knowledge based on 16 items shows an average score of 9.02. The level of knowledge was low to insufficient in 37.21% of cases, average in (50%) half of cases and good for (13.16%). Less than half (34.21%) of pharmacists had received training and the average date of last training was 33.76 ± 24.6 months. Training was provided by medical representatives and academics in 66.66% and 26.67% respectively. The most felt positive feelings were respectively the need for help, the compassion in respectively 98.42%, 42.11%. Feelings felt and simultaneously cited were: need for help and compassion in more than 40% of respondents. Only 29% of pharmacists did not have a lot of difficulty with patient questions and the only reason was the lack of awareness (84.68%) of patients about their disease. Screening for diabetes by capillary blood glucose was performed by 57% of pharmacists. Dietary advice (76.15%) and referral to the hospital (94.41%) were the most common practices in case of blood sugar disruption. The dialogue with patients was impossible in 22.81% of pharmacists and the main reasons given were lack of time (53.85%) and lack of knowledge (34.62%). The method of delivery of insulin was done on: medical prescription (98.25%), presentation of the box (69.30%), on reques

关键词： management Pharmacist Diabetes Dakar

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Dysthyroidism in Elderly Subjects

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Open Journal of Internal Medicine 2020年第2期10卷 181-189页

作者： Diedhiou Demba Diallo Ibrahima mané Gadji Fatou Kiné Sow Djiby ndour Michel Assane Barrage Ahmed Limane Thioye Elhadji mamadou Moussa Ka-Cissé mariama Sarr Anna ndour-mbaye maimouna Department of Internal Medicine II University Hospital Center of Dakar Cheikh Anta Diop University Dakar Senegal

Introduction: Aging is associated with an anatomical and functional heterogeneity of the thyroid which varies according to the iodized status. The aim was to describe the clinical, etiology and therapeutic profile of dysthyroidism in elderly subjects in the internal medicine at the Abass Ndao University Hospital. Patients and methods: This was a retrospective, descriptive and analytical study, including all subjects aged 60 and over followed from January 1, 2010 to December 31, 2019 (10 years) for thyroid disease. Results: 371 Patients were collected with a prevalence of 3.8%. The sex ratio was 0.15 and the mean age was 65.3 years. The circumstances of discovery of the disease were a grade 2 - 3 goiter (62.5%), exophthalmos (24.5%), thyrotoxicosis (56.6%), a symptom of low metabolism (5.4%), a cervical compression (10.8% including 8% of dysphasia), and a cardiothyreosis (9.4%). It was hyperthyroidism (65.2%), and hypothyroidism (7.2%). The main etiologies were toxic multinodular goiter (33.2%), Graves’s disease (29.6%), euthyroidism nodular goiter (26.8%), toxic adenoma (2.4%), and Hashimoto’s thyroiditis (6.7%). The compressive manifestations were exclusive of nodular goiter. Among the 35 cases of cardiothyreosis, there was a rhythm and conduction disorder in 25 cases (6.7%) and the underlying thyreopathy was a toxic nodular goiter in 57.1%. Thyroidectomy involved 44.7% of patients, including 32.6% of Graves’ disease, 48.3% of toxic nodular goiter, and 61.8% of nodular goiter in euthyroidism. We found 02 cases of papillary carcinomas on multinodular goiter. Conclusion: In our hospital series, there is variability in the clinical manifestations of dysthyroidism in the elderly. Complications, mainly cardiac and compressive, remain a major reason for consultation. Toxic nodular goiter is preponderant and its management, especially radical, must be multidisciplinary and according to the profile.

关键词： Elderly Dysthyroidism Internal Medicine Dakar

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Correlation between Glomerulopathy and Retinopathy in an African Population of Type 2 Diabetics

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Journal of Diabetes Mellitus 2020年第2期10卷 64-72页

作者： Michel Assane ndour Jean Pierre Diagne Demba Diedhiou Djiby Sow Esperance Ciss Ibrahima mane Diallo Muriel Diembou El Hadj Fary Ka Papa Amadou Ndiaye Anna Sarr maimouna ndour mbaye Department of Internal Medicine Abass Ndao Hospital Center Dakar Sénégal Department of Ophtalmology Abass Ndao Hospital Center Dakar Sénégal Department of Nephrology Aristide Le DantecHospital Center Dakar Sénégal

Introduction: Diabetic microangiopathies are common, but their time to onset in a diabetic patient varies from subject to subject. The aim of our study was to study the correlation between renal and ophthalmic disorders in patients with type 2 diabetes. Patients and methods: This longitudinal, analytical study took place from march 1, 2018 to march 31, 2019 at the Abass Ndao University Hospital Center. It was studying retinal involvement in diabetic patients with glomerulopathy. Results: Of the 100 cases of diabetic glomerulopathy, they are divided into 70 women and 30 men with an average age of 58.2 years. The average duration of diabetes was 6.1 years and their average glycated hemoglobin (HbA1c) was 8.1%. Only 37% of patients had an HbA1c level below 7%. The other cardiovascular risk factors were high blood pressure (HBP) (39%), dyslipidemia (36%), and obesity (15%). Among these patients, diabetic retinopathy was present in 21% of the cases. Retinopathies were more frequent in the group of patients diagnosed with diabetes for less than 6 years (69%) and in patients with chronic renal disease with slightly reduced glomerular filtration rate (GFR) (34%). Conclusion: Our study allowed us to conclude that during the course of type 2 diabetes, the onset of chronic kidney disease does not systematically imply the presence of diabetic retinopathy. It is thus important to make screenings and assessments of systematic complications.

关键词： Diabetic Retinopathy Diabetic Nephropathy Microangiopathy Daka

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Complementarity of Sentinel-1 and Sentinel-2 Data for mapping Agricultural Areas in Senegal

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Advances in Remote Sensing 2020年第3期9卷 101-115页

作者： Gayane Faye Fama Mbengue Lacina Coulibaly mamadou Adama Sarr Modou mbaye Amath Tall Dome Tine Omar marigo Mouhamadou Moustapha Mbacke ndour Laboratoire de Télédétection Appliquée Institut des Sciences de la Terre Cheikh Anta DIOP University of Dakar (LTA/IST/UCAD) Dakar Senegal Laboratoire de Géomatique Environnementale école de Foresterie Université de Moncton Nouveau-Brunswick Canada Centre de Suivi Ecologique (CSE) of Dakar Dakar Senegal Laboratoire d’études et de Recherche en Statistique et Développement UFR de Sciences Appliquées et de Technologie Département de Mathématiques Appliquées Université Gaston BERGER of Saint-Louis Dakar Senegal Ecole Nationale Supérieure d’Agriculture (ENSA) Thies University Thies Senegal UFR Science de l’Ingenieur Thies University Thies Senegal

The small size of agricultural plots is the main difficulty for crops mapping with remote sensing data in the Sahelian region of Africa. The study aims to combine Sentinel-1 (radar) and Sentinel-2 (Optic) data to discriminate millet, maize and peanut crops. Training plots were used in order to analyse temporal variation of the three crops’ signals. The NDVI (Normalized Difference Vegetation Index) was able to differentiate crops only at the end of the rainy season (October). The optical data as well as the radar ones could not easily discriminate the three crops during the growing season, because in that period vegetation cover is low, and soil contribution to the signals (due to roughness and moisture) was more important than that of real vegetation. However, the ratio of VH/VV (VH: incident signal in vertical polarization and reflected signal in horizontal polarization;VV: incident signal in vertical polarization and reflected signal in horizontal polarization) gave a difference between millet and the two other crops at the beginning cultural season (July 11). Difference appears from the second third of September when the harvest of cereals crops (millet and maize) began. From middle of October, the peanut signal dropped sharply thus facilitating the differentiation of peanut from the two other crops. This analysis led to the identification of data that have could be used to discriminate these crops (useful data). Classification of the combined useful data gave an overall high accuracy of 82%, with 96%, 61% and 65% for peanut, maize and millet, respectively. The non-agricultural areas (water, natural vegetation, habit, bare soil) were well classified with an accuracy greater than 90%.

关键词： Agricultural Areas Remote Sensing Sentinel-1 Sentinel-2 Senegal

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Profile of Biermer’s Disease at the Medical Clinic II Abass Ndao Hospital Center: About 57 Colliged Cases

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Open Journal of Internal Medicine 2020年第2期10卷 141-150页

作者： Michel Assane ndour Djiby Sow Demba Diedhiou Boundia Djiba Ibrahima mané Diallo Alassane Baro Jeanne Anna Bentaux Muriel Diembou marie Louise Bassene maimouna ndour mbaye Fatou Samba Diago Ndiaye Anna Sarr Department of Internal Medicine Abass Ndao Hospital Center Dakar Senegal Department of Gastroenterology Aristide Le Dantec Hospital Center Dakar Senegal Department of Hematology Dalal Djam Hospital Center Dakar Senegal

Introduction: Biermer’s disease is an autoimmune cause of anemia characterized by malabsorption of vitamin B12. It is often accompanied by other autoimmune pathologies. The objective was to study its profile in patients followed in the internal medicine department of the Abass Ndao hospital center. Methods: This was a retrospective and descriptive study of patients followed for Biermer’s disease from January 1, 2014 to December 31, 2019 (5 years). Results: 57 cases were collected, an incidence of 5.4 in the internal medicine department. The sex ratio was 0.58, an average age of 56.4 years. The circumstances of discovery were dominated by anemic syndrome (87.7%), dermatological (33.3%), digestive (29.8%), neurological (20%) pathologies. The specific signs to Biermer’s disease were digestive manifestations in 70.2% (including 30% Hunter’s glossitis), neurological manifestations in 36.8% (including 17.5% paresthesias), palmoplantar melanoderma in 68.4%. The mean hemoglobin level was 6.8 g/dL with a mean corpuscular volume of 110.7 fl. The myelogram reported megaloblastosis in 100% of the cases. The mean serum vitamin B12 level was 100 pg/ml. The anti-intrinsic factor antibody assay performed in 50 patients was positive in all cases. Upper digestive endoscopy showed an aspect of fundic atrophy in 69%. Histology showed intestinal metaplasia in 2 patients. An autoimmune disease was associated in 21% of cases. All patients had received treatment with vitamin B12 (51 patients took intramuscularly and 6 oral treatment). The course was favorable in all cases with a complete correction of the anemia. Conclusion: Biermer’s disease is a reality in Senegal. Its clinical and biological characteristics can be superimposed on the data in the literature. His prognosis under treatment is good whatever the route of administration of vitamin B12.

关键词： Biermer Autoimmune Disease Vitamin B12 Dakar

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Rosai Dorfman Destombes’s Disease about 5 Cases

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Open Journal of Internal Medicine 2020年第2期10卷 212-222页

作者： Michel Assane ndour Boundia Djiba Baï di Sy Kane Pape Guirane Ndiaye Demba Diedhiou Mouhamed Dieng Barane Thiam Rosa Bampoky Muriel Diembou Atoumane Faye maimouna ndour mbaye Anna Sarr Abdoulaye Pouye Department of Internal Medicine Abass Ndao Hospital Center Dakar Senegal Department of Internal Medicine Aristide Le Dantec Hospital Center Dakar Senegal

Rosai Dorfman’s Disease (RDD) Destombes also called sinus histiocytosis with massive lymphadenopathy is a lymphoproliferative pathology usually benign, of unknown etiology, and of low incidence. It is a rare, but well-defined clinicopathological entity, which predominantly affects children and adolescents without distinction of gender or race. It manifests itself generally by bulky cervical lymphadenopathies, most often bilateral, painless, of benign but persistent evolution and a long-term fever associated with a non-specific biological inflammatory syndrome. Extra lymph node locations are described in association with lymph node involvement or isolation. The definitive diagnosis of Rosai Dorfman’s disease is histological, characterized by histiocytic infiltration with emperipolesis essentially of lymphocytes. The etiopathogenesis of the condition remains unclear, based on infectious and immunological hypotheses without clear evidence. The management is not well codified, it combines depending on the case, surgery;corticosteroids;antimetabolites and interferon alpha. Studies devoted to this condition in tropical Africa are rare. We report the clinical and progressive features of 5 observations of Rosai Dorfman’s disease.

关键词： Rosai Dorfman Histiocytosis Dakar

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