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Efficacy and Risk Factors Associated to Resistance to Single-Agent Chemotherapy in Low-Risk Gestational Trophoblastic Neoplasia

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Open Journal of Obstetrics and Gynecology 2016年第1期6卷 50-55页

作者： Mamour gueye mame diarra ndiaye-gueye Serigne Modou Kane-gueye Fatou Niass Dia Aissatou Thiam Sr. Elisabeth Diouf Jean Charles Moreau Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal

Objectives: This study aimed to assess efficacy of intramuscular methotrexate 8-day protocol in the treatment of low-risk gestational trophoblastic neoplasia and also identify prognostic factors associated with treatment failure, necessitating second line chemotherapy. Methods: This study was performed at Gynaecologic and Obstetric Clinic of Dakar Teaching Hospital, the reference Centre of Gestational Trophoblastic Disease in Senegal. At the beginning of 2011, patients were followed according to FIGO’s recommendations. From 2011 to 2014, we diagnosed 88 low-risk gestational trophoblastic neoplasia (GTN) patients (WHO score < 7). Low-risk patients started their treatment with methotrexate (MTX) based on the 8-day protocol consisting of 1 mg/kg MTX in combination with 0.1 mg/kg folinic acid (FA) every other day. Resistance to treatment was the main outcome. We studied the association of different prognostic factors included in the World Health Organisation (WHO) scoring system and resistance to the initial single agent chemotherapy. Results: Eighty-eight patients were diagnosed for GTN during the study period. Average age was 31 years. The antecedent pregnancy was molar in 98.1% of cases. Seventy-four patients underwent remission after single agent-chemotherapy. Resistance rate to single-agent chemotherapy was 15.9% (14 patients). Nine of them achieved remission after second line chemotherapy. WHO score was significantly associated with the risk of resistance to single-agent chemotherapy. Other variables included in the WHO as age, antecedent pregnancy, pre-treatment hCG, tumour size and FIGO stage were not significantly associated with resistance. We report five fatal cases. Conclusion: The 8-day protocol consisting of 1 mg/kg MTX in combination with 0.1 mg/kg folinic acid (FA) every other day is effective for women with LRGTN. The only significant prognostic factor for failure is pretreatment WHO score. We highly recommend the use of this protocol particularly in de

关键词： Gestational Trophoblastic Neoplasia Chemotherapy International Federation of Gynecology and Obstetrics Resistance

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Assessment of a Database Management System in a Mammogram Unit of a Radiologic Department in Fann Teaching Hospital (Senegal)

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2017年第4期6卷 401-409页

作者： Mamour gueye Awa Sadikh Badiane Sokhna Ba Diop Mamadou Ly mame diarra ndiaye gueye Abdoulaye Dione Diop Abdoulaye Ndoye Diop Marame Fall Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Dakar Senegal Department or Radiology Fann Teaching Hospital Dakar Senegal

Objectives: To evaluate a medical data management system of a mammogram unit in a department of Radiology. Methods: This is a qualitative and quantitative assessment study in Fann Teaching Hospital between April 2014 and June 2015 one year after its implementation. The quantitative component consisted of the audit of the database to determine the socio-demographic characteristics of patients and the results of mammograms. The qualitative component assessed users’ experience. For analysis, quantitative data were extracted and transferred to Microsoft Excel. For scale variables, we calculated the averages and extremes. For qualitative variables, we established percentages. Results: During the study period, 433 patients underwent mammograms. The average age of patients was 48 years. The completion rate maintained above 85% was below 26% in the first two months of use. As to the completeness given examinations, it was still above 83%. The results of mammogram examinations were normal in the majority of cases: 96% for the right breast and 95.2% for the left breast. All users had a favourable opinion about the database. The reasons were better work organization, comprehensiveness, accessibility and standardization of information about the patient and especially the immediate availability of statistics. For 60% of these health professionals, complaints related to the use of the software were the time-consuming of filling data. Conclusion: This study mainly describes the perception of health professionals on the computerization of radiological examinations. It offers some advantages, proposes improvements and opens avenues for reflection on the globalization of the computerization of patient records in Radiology.

关键词： Electronic Medical Records Database Mammogram Radiology Dakar

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Epidemiology and Prognosis of Retroplacental Hematoma in a Maternity Ward at a Regional Hospital Center in Southern Senegal

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Open Journal of Obstetrics and Gynecology 2019年第2期9卷 149-157页

作者： Babacar Biaye Omar Gassama mame diarra ndiaye gueye Moussa Diallo Aminata Niass Mor Cisse Alassane Diouf Jean Charles Moreau Gynecological and Obstetric Clinic University Hospital Aristide Le Dantec Dakar Senegal

Objectives: To study the epidemiological profile and the prognosis of the retro-placental hematoma (HRP) at the maternity ward at Kolda Regional Hospital Center. Materials and methods: This was a retrospective descriptive cross-sectional study conducted over a period of 11 years: from January 1st, 2006 to December 31st, 2016, at Kolda Regional Hospital Center. It included all patients admitted for HRP during this period. The studied parameters concerned sociodemographic characteristics, gynecological obstetrical history;clinical, therapeutic and prognostic data (non-inclusion or exclusion criteria). The data were collected from medical records, the delivery room and the surgery room registers using a collection sheet developed for this purpose. The statistical analysis of the variables studied was done with the software Epi-info 3.5. For the qualitative variables, we calculated the frequencies and for the quantitative variables, we studied the distributions. Results: During the study period, 15,343 were recorded deliveries and we carried out the diagnosis of HRP in 301 patients (1.97%). The average age of the patients was 24 years with an average parity of 4.8 deliveries. Almost all the patients (87.5%) were evacuated and half had delivered by caesarean section. Maternal and fetal deaths were 7% and 72.1%, respectively. Uterine atony accounted for 21.2% of complications. One third of the cases of uterine atony had resulted in a hysterectomy. The average duration of hospitalization was 6 days. Conclusion: The retro-placental hematoma is a serious medico-obstetric emergency. It is burdened with high maternal and fetal morbidity and mortality in developing countries.

关键词： Retro-Placental Hematoma Mortality Kolda

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The Caesarean Section in Dakar: Indications and Analysis Prognosis

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Open Journal of Obstetrics and Gynecology 2019年第9期9卷 1213-1220页

作者： Moussa Diallo Marie Edward Faye Dieme Omar Gassama Astou Coly Niassy Diallo mame diarra ndiaye gueye Jean Charles Moreau Service de Gynécologie-Obstétrique Centre Hospitalier National de Pikine Sis Camp de Thiaroye Dakar Sénégal Clinique Gynécologique et Obstétricale de l’Hopital Aristide Le Dantec Dakar Sénégal

The objective of this study was to analyze the indications of cesarean sections performed in a Level II clinic and to evaluate early maternal and neonatal outcome in the context of decentralization of obstetric and emergency newborn care. Material and Method: This was a retrospective descriptive and analytical study conducted at the maternity CSNC over a period of 12 months from 1 July 2010 to 30 June 2011. It included all women in childbirth by caesarean section and excluded patients admitted for management of complications of cesarean section performed in another structure. Results: During the study period, 595 caesarean sections were performed on a total of 4410 births, a rate of 13.5%. The average age of patients was 27 years. The mean parity was 2. The patients came from them even 55%. They were admitted with a single uterine scar in 28.40% of cases and bi-scar in 25.4% of cases. A pathology was associated with pregnancy in 31.6% of cases. These pathologies were dominated by vascular and renal syndromes (75.5%), anemia (13.8%) and the obstacles previa (10.1%). Caesarean sections were performed in 517 patients in emergency. The technique of Misgav Ladach was the most common 75.1%. The average hospital stay was 4.2 days with extremes of 0 and 15 days. Postoperative maternal mortality was 0.34%. Operative follow-up was simple in 98.3% of patients. Two patients (0.34%) died after surgery. In 92.4% of the cases, the newborns were alive. The Apgar score in the first minute was favorable (greater than or equal to 7/10) in 503 newborns (95.1%) and unfavorable (less than 7/10) in 47 cases (8.55%). At the fifth minute, he was favorable in 98.5% of the cases. Overall stillbirth was 72.26‰ with a total of 43 stillbirths including 3 macerated stillbirths. Conclusion: Cesarean section is by far the most accomplished action in gynecology and obstetrics. Its ease of implementation and low cost, and of course his results in terms of reduction of maternal-fetal morbidity and mor

关键词： Cesarean Section Indication Misgav Ladach Maternal and Fetal Prognosis

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How to Avoid Primary Caesarean Section? A Five-Year Experience Report from a Level 2 Facility in Dakar Senegal

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Open Journal of Obstetrics and Gynecology 2017年第12期7卷 1174-1182页

作者： mame diarra ndiaye gueye Mamour gueye Magatte Mbaye Abdelouahed Chraibi Aliou Diouf Mouhamadou Wade Moussa Diallo Omar Gassama Mor Cisse Youssoupha Toure Moustapha Thiam Jean Charles Moreau Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta DIOP University Dakar Senegal

Objectives: The aim of this study was to analyse key factors and main indications of primary caesarean sections and find out ways to reduce the rising rates. Patients and method: This was a longitudinal and retrospective study carried out from 1 January 2012 to 31 December 2016. The study included all patients in whom a primary CS was performed. A previous uterine scar was a non-inclusion criterion. We analysed the main indications and their trends during these five years, Apgar score at the 5th minute according to the course of caesarean section rate and the impact of daily audit. Data were collected retrospectively from 2012 to 2015, then prospectively in 2016 using a Filemaker database. Data were analysed with SPSS 21 software, Mac version. Averages were calculated for quantitative data and percentage for qualitative ones. The statistical tests used were the Pearson Chi2 test. The differences observed were considered significant when the p value was less than 0.05. Results: During the study period, we registered 21.308 deliveries and 6.292 caesarean sections (29.5%). Primary CS concerned 72.5% of overall CS. The main indications were suspicious of fetal distress (29.1%), obstructed or prolonged labour (21.7%), breech and twin delivery with respectively 8.2% and 5.2%. We registered more vaginal deliveries with induction of labour: 81.4% versus 75.2%. An obstetrical audit allowed better management of labour and decrease of CS rate. Conclusion: We need to focus on diagnosis of fetal distress, management of breech presentation in twin delivery and singleton. The induction of labour can be an effective alternative in some indications. An obstetrical audit is necessary to reverse caesarean section rate.

关键词： Caesarean Section Rate Indications Apgar Score Obstetrical Audit

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Improving Postpartum Haemorrhage Management Using Simulation in Senegal: Midterm Results

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Open Journal of Obstetrics and Gynecology 2017年第13期7卷 1292-1299页

作者： Mamour gueye Moussa Diallo mame diarra ndiaye gueye Omar Gasama Abdoul Aziz Diouf Mouhamadou Mansour Niang Mohamed Diadhiou Astou Coly Niassy Serigne Modou Kane gueye Marie Edouard Faye Dieme Magatte Mbaye Philippe Marc Moreira Alassane Diouf Jean Charles Moreau Gynecologic and Obstetric Clinic Aristide Le Dantec Teaching Hospital Cheikh Anta Diop University Dakar Senegal

Objective: To assess a training approach in Emergency Obstetric and Neonatal Care (EmONC) to strengthen skills of healthcare providers and reduce maternal mortality. Materials and methods: The approach was based on the skills training using the so-called “humanist” method and “life saving skills”. Simulated practice took place in the classroom through thirteen clinical stations summarizing the clinical skills on EmONC. The evaluation was done in all phases and the results were recorded in a database to document the progress of each learner. Results: We trained 432 providers in 10 months. The increase in technical achievements of each participant was documented through a database. The combination of training based on the model “learning by doing” has ensured learning and mastering all EmONC skills particularly postpartum haemorrhage management and reduced missed learning opportunities. Conclusion: The impact of training on postpartum haemorrhage management and maternal mortality is a major challenge in terms of prospects.

关键词： Emergency Obstetric Care Postpartum Haemorrhage Training Simulation

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Seasonal Performance of Solar Power Plants in the Sahel Region: A Study in Senegal, West Africa

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Smart Grid and Renewable Energy 2024年第2期15卷 79-97页

作者： Serigne Abdoul Aziz Niang Mamadou Simina Drame Astou Sarr mame diarra Toure Ahmed gueye Seydina Oumar ndiaye Kharouna Talla FST D&#233partement de Physique Universit&#233 Cheikh Anta Diop de Dakar Dakar S&#233n&#233gal Laboratoire de Physique de l’Atmosphère et de l’Océan Siméon Fongang Université Cheikh Anta Diop Dakar Sénégal

The main objective of this study is to evaluate the seasonal performance of 20 MW solar power plants in Senegal. The analysis revealed notable seasonal variations in the performance of all stations. The most significant yields are recorded in spring, autumn and winter, with values ranging from 5 to 7.51 kWh/kWp/day for the reference yield and 4.02 to 7.58 kWh/kWp/day for the final yield. These fluctuations are associated with intense solar activity during the dry season and clear skies, indicating peak production. Conversely, minimum values are recorded during the rainy season from June to September, with a final yield of 3.86 kWh/kW/day due to dust, clouds and high temperatures. The performance ratio analysis shows seasonal dynamics throughout the year with rates ranging from 77.40% to 95.79%, reinforcing reliability and optimal utilization of installed capacity. The results of the capacity factor vary significantly, with March, April, May, and sometimes October standing out as periods of optimal performance, with 16% for Kahone, 16% for Bokhol, 18% for Malicounda and 23% for Sakal. Total losses from solar power plants show similar seasonal trends standing out for high loss levels from June to July, reaching up to 3.35 kWh/kWp/day in June. However, using solar trackers at Sakal has increased production by up to 25%, demonstrating the operational stability of this innovative technology compared with the plants fixed panel. Finally, comparing these results with international studies confirms the outstanding efficiency of Senegalese solar power plants, other installations around the world.

关键词： Performance Study Photovoltaic Power Plant Season Variations Senegal

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Epidemiology of Cardiovascular Mortality in Patients under 60 Years Old in a Cardiology Department in West Africa, Dakar-Senegal

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World Journal of Cardiovascular Diseases 2024年第8期14卷 502-514页

作者： Aliou Alassane Ngaide Ngone Diaba Gaye Joseph Salvador Mingou mame diarra Sene Momar Dioum Mouhamadou Bamba ndiaye Alassane Mbaye Abdoul Kane Faculty of Medicine University Cheikh Anta Diop of Dakar Dakar Senegal Cardiology Department Dalal Jamm Hospital Dakar Senegal Cardiology Department Aristide Le Dantec Hospital Dakar Senegal Cardiology Department Idrissa Pouye General Hospital Dakar Senegal Cardiology Department Fann Hospital Dakar Senegal

Background: Our study aimed to examine cardiovascular mortality within the working-age population, exploring epidemiological, clinical, and paraclinical features, complications, and identifying etiological factors linked to mortality. Methods: We conducted a descriptive and analytical retrospective study from September 2019 to August 2022 at the General Hospital Idrissa POUYE in Dakar, we reviewed all the medical records of patients from 15 to 60 years old who died while admitted in the cardiology department. Data collected were socioeconomic status, clinical history, type of cardiovascular disaese, length of hospitalization, circumstances and timing of death. The data were analyzed with R. Studio version 2022.12.0 + 353 and Excel 2019, with a P-value Results: The study included 73 patients, indicating a specific mortality rate of 8.8% and a proportional mortality of 39%. Predominantly male (sex ratio 1.2), the average age was 44. Key cardiovascular risk factors identified were sedentarism (76.7%), hypertension (28.8%), and smoking (21.9%). The leading cause for consultation was dyspnea (72.6%). Notable findings included a majority of patients presenting with general condition deterioration (90%) and cardiovascular collapse upon admission (23.3%). Physical exam revealed signs of heart failure in 63%. Echocardiography showed left ventricular ejection fraction impairment (81%) and pulmonary hypertension (78%). Immediate causes of death were primarily cardiogenic shock (45.2%) and septic shock (37%). The analytical study indicates that the data most closely associated with mortality were age, socio-economic level, ischemic heart disease (p = 0.034), rheumatic valvulopathies, pulmonary embolism (p = 0.034), hypertension (HTA) (p = 0.009), smoking (p = 0.011), diabetes (p = 0.011), dyslipidemias, prolonged bedrest (p = 0.001), morbid obesity (p = 0.001), and COVID-19 infection (p = 0.017). Conclusion: The prevalence of ischemic heart diseases, pulmonary embolisms, and va

关键词： Mortality Under 60 Years Cardiovascular Dakar

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Sweetener and Flavor Enhancer Food Additives in Industrial Food Products Marketed in Dakar: Frequency and Diversity

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Open Journal of Applied Sciences 2024年第1期14卷 101-117页

作者： Alé Kane Alioune Sow Ndèye Adiara ndiaye Coumba gueye Sagna Papa Amadou Diakhaté Mady Cissé Amadou Diop Laboratoire des Sciences Biologiques Agronomiques Alimentaires et de Modélisation des Systèmes Complexes (LABAAM) Université Gaston Berger (UGB) Saint-Louis Senegal Département des Technologies Agroalimentaires|UFR des Sciences Agronomiques de l’Aquaculture et des Technologies Alimentaires (S2ATA) Saint-Louis Senegal Ecole Supérieure Polytechnique (ESP) Dakar Senegal Laboratoire de chimie analytique et bromatologie UCAD Dakar Senegal

Sweeteners and flavor enhancers are food additives widely used in industry, respectively, to add sweetness and flavor to foods. However, the presence of these substances is often criticized by consumers for their effects on health. What’s more, some scientific studies link these substances to certain pathologies. To guarantee food safety, competent authorities should have food standards based on risk analysis using consistent, reliable data. However, in developing countries, such data is often weak or non-existent. The aim of this study is therefore to carry out a pilot survey to establish the profile of sweeteners and flavour enhancers present in industrial food products marketed in Senegal. The methodology consisted of sampling various food products sold on the Senegalese market, based on analysis of labels containing information on ingredients, including additives. The investigation involved nine stores, one supermarket and 5 mini-markets in Dakar. The results showed the presence of 6 taste enhancers in food products, the most frequent being sodium L-monoglutamate (E621), inosinate (E631) and disodium guanylate (E627). Solid broths are the foodstuffs with the highest number of taste exhalters. As for sweeteners, 12 substances were identified, the most frequent being acesulfame potassium (E950), aspartame (E951), sucralose (E955) and saccharin (E954). Given the potential health risks associated with the consumption of these food additives, their control and monitoring on the market should be a priority for the competent authorities.

关键词： Exhalter Sugar Acesulfame Potassium Sodium Monoglutame Artificial Health Risk

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Superior Mesenteric Artery Syndrome, a Rare Complication of Severe Malnutrition: Two Cases from a Subsaharian Endocrinology Department

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Open Journal of Endocrine and Metabolic Diseases 2024年第4期14卷 87-93页

作者： Nafy ndiaye Ngone Diaba Diack Yakham Mohamed Leye Sokhna Awa Balla Sall Moussa gueye Mouhamed Fawaz Mouhamadou Moustapha Ndong Abdoulaye Leye Department of Internal Medecine and Endocrinology Teaching Hospital of Pikine Dakar Senegal

Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m2, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.

关键词： Superior Mesenteric Artery Syndrome Malnutrition Pikine

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